Bashir Ahmad Junjua, Khadija, Samina, Aftab Ahmad.
Morphological study of anatomical variations in the branching pattern of human axillary arterial system.
J Sheikh Zayed Med Coll Jan ;2(3):200-6.

Background: The arterial variations in the upper extremities are quite common and may occur at the level of axilla, arm, cubital fossa and the hand. Knowledge of anatomical variations in the branching pattern of axillary artery is very important in medical & surgical practices. Objectives: To determine the anatomical variations in the branching pattern of axillary arterial system in cadavers. Secondarily, to avoid the injuries by applying this knowledge during clinical practice. Material and Methods: A total of 82 upper limbs of 41 human embalmed cadavers of both sexes (36 Males & 5 Females,) ranging from (45-70 years old) were dissected and examined at the department of Anatomy, Nishtar Medical College, Multan, Army Medical College, Rawalpindi and Sheikh Zayed Medical College, Rahim Yar Khan over a period of four years. Upper limbs were labeled from 1-82 with letters (R) and (L) corresponding to the right or left limbs respectively and letters (M) or (F) corresponding to male or female respectively. Axillary artery (AA) with its normal or variant branches along with brachial plexus with its cords and branches was exposed in each cadaver. The topographic detail of each AA and its branching pattern deviated from the normal pattern was identified and photographed in both upper limbs of each cadaver. Results: The anomalous topographic pattern of branches of axillary arterial system was revealed in 14.64 % of the cadavers. Among 41(82 limbs) cadavers, the total anomalous branching pattern of AA were found in 6 (14.64 %) dead bodies, out of which 4 (9.76%) male and 2 (4.88%) female cadavers were seen. The frequency of bilateral variation was found in 1 (2.44%) male and 1 (2.44%) female cadavers but the frequency of unilateral variation was in 3 (7.32%) male dead bodies and in 1 (2.44 %) female cadaver. The study showed that axillary artery of the various cadavers gave origin to anamolous common thoraco- subscapular-circumflex humeral trunk in 5 (6.09 %) limbs, common circumflex humeral trunk in two (2.44%) limbs directly from the third part of the AA, independent branches from the different parts of the axillary artery (AA) were found in 4 cadavers i.e. in 6 (7.32 %) limbs and common thoracic trunk got origin from the 1st part of the AA in one (1.22 %) case. Conclusion: Our study reports existence of anomalous branches of AA. Knowledge of variation is very important during surgical exploration of the regions like axilla, arm and during flap or reconstructive surgeries. The anomalous branching pattern of AA associated with anomalies of various nerves are of interest to anatomists, surgeons, and radiologists, so keeping in view such anomalies, it is suggested that before doing any flap or reconstructive surgeries, these anomalies must be evaluated pre-operatively. Key Words: Axillary artery, variations, anomalies, superior thoracic, thoraco-acromial, lateral thoracic, subscapular, anterior circumflex humeral, posterior circumflex humeral, thoracodorsal. angiographers

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