Variant Course of Posterior Circumflex Humeral Artery Associated with the Abnormal Origin of Radial Collateral Artery: Could It Mimic the Quadrangular Space Syndrome?
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Kappettu Gadahad Mohandas Rao
,
Shiroor Nagabhushan Somayaji
,
Lagadamane Sathyanarayana Ashwini
,
Swamy Ravindra
,
Padavinangadi Abhinitha
,
Ashutosh Rao
,
Marpalli Sapna
,
Patil Jyothsna
Abstract
Variations in the origin of axillary artery branches are common. But, distinctly abnormal course of its posterior circumflex humeral branch is rare. We are reporting a case of posterior circumflex humeral artery (PCHA) originating from the axillary artery, passing through lower triangular space to reach the scapular region where it accompanied the axillary nerve and posterior circumflex humeral vein to pass around surgical neck of humerus, deep to the fibers of deltoid. Other variations observed in this specimen were the radial collateral artery arising from the PCHA, middle collateral artery arising directly from the brachial artery and absence of profunda brachii artery. PCHA forming a hair pin loop, traversing through lower triangular space instead of quadrangular space taking a long course is being reported for the first time. Further, the clinical and surgical importance of this case especially in relation with quadrangular space syndrome and relevant literature is discussed.
Standring S, Borley NR, Collins P, Crossman AR, Gatzoulis MA, Healy JC, Johnson D, Mahadevan V, Newell RLM, Wigley CB, editors. Gray’s Anatomy: The Anatomical Basis of Clinical Practice. 40th ed. London: Elsevier, Churchill Livingstone; 2008. p. 815-28.
Chautems RC, Glauser T, Waeber-Fey MC, Rostan O, Barraud GE. Quadrilateral space syndrome: case report and review of the literature. Ann Vasc Surg 2000;14(6):673-6.
Okino S, Miyaji H, Matoba M. The quadrilateral space syndrome. Neuroradiology 1995;37(4):311-2.
Cormier PJ, Matalon TA, Wolin PM. Quadrilateral space syndrome: a rare cause of shoulder pain. Radiology 1988;167(3):797-8.
Olinger A, Benninger B. Branching patterns of the lateral thoracic, subscapular, and posterior circumflex humeral arteries and their relationship to the posterior cord of the brachial plexus. Clin Anat 2010;23(4): 407-12.
Sharma T, Singla RK, Sachdeva K. Bilateral superficial brachial artery. Kathmandu Univ Med J (KUMJ) 2009;7(28):426-8.
Baral P, Vijayabhaskar P, Roy S, Kumar S, Ghimire S, Shrestha U. Multiple arterial anomalies in upper limb. Kathmandu Univ Med J (KUMJ) 2009;7(27):293-7.
Casoli V, Kostopoulos E, Pélissier P, Caix P, Martin D, Baudet J. The middle collateral artery: anatomic basis for the "extreme" lateral arm flap. Surg Radiol Anat 2004;26(3):172-7.
Patnaik, VVG, Kalsey G, Singla Rajan K. Branchingpattern of brachial artery: a morphological study. Anat Soc India 2002;51(2):176-86.
Mohandas Rao KG, Bhat SM, Vollala VR. Unusual origin of radial collateral artery noted in quadrangular space syndrome. J Chin Med Assoc 2006;69(6):276-7.
Duparc F, Muller JM, Fréger P. Arterial blood supply of the proximal humeral epiphysis. Surg Radiol Anat2001;23(3):185-90.
Hue E, Gagey O, Mestdagh H, Fontaine C, Drizenko A, Maynou C. The blood supply of the deltoid muscle. Application to the deltoid flap technique. Surg Radiol Anat 1998;20(3):161-5.
Determe D, Rongières M, Kany J, Glasson JM, Bellumore Y, Mansat M, Becue J. Anatomic study of the tendinous rotator cuff of the shoulder. Surg Radiol Anat 1996;18(3):195-200.
Vlychou M, Spanomichos G, Chatziioannou A, Georganas M, Zavras GM. Embolisation of a traumatic aneurysm of the posterior circumflex humeral artery in a volleyball player. Br J Sports Med 2001;35(2):136-7.
Cahill BR, Palmer RE. Quadrilateral space syndrome. J Hand Surg Am 1983;8(1):65-9.
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| Issue | Vol 50, No 8 (2012) | |
| Section | Articles | |
| Keywords | ||
| Posterior circumflex humeral artery Quadrangular space syndrome Radial collateral artery Triangular space | ||
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