Vol 78, No 4 (2019)
Case report
Published online: 2019-02-25

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An unusual case of asymmetrical combined variations of the subclavian and axillary artery with clinical significance

E. Panagouli1, K. Natsis2, M. Piagkou1, G. Kostare1, G. Tsoucalas3, D. Venieratos1
Pubmed: 30816550
Folia Morphol 2019;78(4):883-887.

Abstract

In a Greek Caucasian male cadaver, a combination of the following arterial variations were observed: an aberrant right subclavian artery originating as a last branch of the aortic arch and coursed posterior to the oesophagus, a right non-recurrent laryngeal nerve, an atypical origin of the left suprascapular artery from the axillary artery, an unusual emersion of the lateral thoracic artery from the subscapular artery and a separate origin of the left thoracodorsal artery from the axillary artery. According to the available literature the corresponding incidences of the referred variants are: 0.7% for the aberrant right subclavian artery, 1.6–3.8% for the origin of the suprascapular artery from the axillary artery, 3% for the origin of the left thoracodorsal artery from the axillary artery and 30% for the origin of the lateral thoracic artery from the subscapular artery. Such unusual coexistence of arterial variations may developmentally be explained and has important clinical significance.

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References

  1. Bhatia K, Ghabriel MN, Henneberg M. Anatomical variations in the branches of the human aortic arch: a recent study of a South Australian population. Folia Morphol. 2005; 64(3): 217–223.
  2. Cavdar S, Zeybek A, Bayramiçli M. Rare variation of the axillary artery. Clin Anat. 2000; 13(1): 66–68.
  3. Celikyay ZR, Koner AE, Celikyay F, et al. Frequency and imaging findings of variations in human aortic arch anatomy based on multidetector computed tomography data. Clin Imaging. 2013; 37(6): 1011–1019.
  4. Davidian M, Kee ST, Kato N, et al. Aneurysm of an aberrant right subclavian artery: treatment with PTFE covered stentgraft. J Vasc Surg. 1998; 28(2): 335–339.
  5. Feugier P, Lemoine L, Gruner L, et al. Arterioesophageal fistula: a rare complication of retroesophageal subclavian arteries. Ann Vasc Surg. 2003; 17(3): 302–305.
  6. Havet E, Duparc F, Tobenas-Dujardin AC, et al. Vascular anatomical basis of clavicular non-union. Surg Radiol Anat. 2008; 30(1): 23–28.
  7. Karacan A, Türkvatan A, Karacan K. Anatomical variations of aortic arch branching: evaluation with computed tomographic angiography. Cardiol Young. 2014; 24(3): 485–493.
  8. Kobayashi M, Yuta A, Okamoto K, et al. Non-recurrent inferior laryngeal nerve with multiple arterial abnormalities. Acta Otolaryngol. 2007; 127(3): 332–336.
  9. Lamb DD. Radical neck dissection. Surg Technol. 2010: 449–454.
  10. Lippert H, Pabst R. Arterialvariations in man. Classification and Frequency. Bergmann, Muenchen 1985.
  11. Mishra S, Ajmani ML. Anomalous origin of suprascapular artery–a case report. J Anat Soc India. 2003; 52(2): 180–182.
  12. Natsis K, Lazaridis N, Gkiouliava A, et al. Retro-oesophageal right subclavian artery in association with thyroid ima artery: a case report, clinical impact and review of the literature. Folia Morphol. 2016; 75(1): 130–135.
  13. Natsis KI, Tsitouridis IA, Didagelos MV, et al. Anatomical variations in the branches of the human aortic arch in 633 angiographies: clinical significance and literature review. Surg Radiol Anat. 2009; 31(5): 319–323.
  14. Natsis K, Didagelos M, Gkiouliava A, et al. The aberrant right subclavian artery: cadaveric study and literature review. Surg Radiol Anat. 2017; 39(5): 559–565.
  15. Polguj M, Chrzanowski Ł, Kasprzak JD, et al. The aberrant right subclavian artery (arteria lusoria): the morphological and clinical aspects of one of the most important variations--a systematic study of 141 reports. Scientific World J. 2014; 2014: 292734.
  16. Popieluszko P, Henry BM, Sanna B, et al. A systematic review and meta-analysis of variations in branching patterns of the adult aortic arch. J Vasc Surg. 2018; 68(1): 298–306.e10.
  17. Pyrgakis P, Panagouli E, Venieratos D. Anomalous origin and course of the suprascapular artery combined with absence of the suprascapular vein: case study and clinical implications. N Am J Med Sci. 2013; 5(2): 129–133.
  18. Robinson CM. Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surg Br. 1998; 80(3): 476–484.
  19. Singh R. Variations in the origin and course of the suprascapular artery: case report and literature review. J Vasc Bras. 2018; 17(1): 61–65.
  20. Standring, S.; Borley, N.R.; Collins, P. (eds.): Gray’s anatomy. The anatomical basis of clinical practice. E Elsevier, Edinburgh 2008.
  21. Tapia GP, Zhu X, Xu J, et al. Incidence of branching patterns variations of the arch in aortic dissection in Chinese patients. Medicine (Baltimore). 2015; 94(17): e795.
  22. Tountas CP, Bergman RA. Anatomic variations of the upper extremity. Churchill Livingstone 1993.
  23. Uglietta JP, Kadir S. Arteriographic study of variant arterial anatomy of the upper extremities. Cardiovasc Intervent Radiol. 1989; 12(3): 145–148.