Axillary arch in Bulgarian population: Clinical significance of the arches

Abstract

In order to study the incidence of the axillary arch in the Bulgarian population, we examined the axillary regions of 56 formol-carbol fixed human cadavers and observed two cases with a unilateral axillary arch. In the first case, the variant structure was situated on the right side of a 58-year-old female cadaver. The axillary arch extended from the lateral border of the latissimus dorsi to the posterior layer of the pectoralis major tendon. In the second case, the axillary arch was found on the left side of a 63-year-old male cadaver and had the same attachment points as in the first case. The innervation and blood supply of the arches are discussed. We have also reviewed extensive information concerning the clinical importance of the axillary arch, and for the first time, it was summarized clearly for clinicians. The summary consists of three parts: "diagnosis" of the axillary arch by physical investigation or imaging techniques; the axillary arch and surgical interventions in the region of the axilla; the axillary arch as an entrapment site for the axillary vessels and nerves.

Axillopectoral Muscle- A Unilateral Musculotendinous Arch

“…In Japanese, the prevalence of axillary arch is found to be 9.1% (8) and 5.3% (9) in two different studies on 176 and 94 body halves respectively. Prevalence of this variation in Turkish population reported as 1.9% in 26 cadavers (3) , where in Bulgarian population reported as 3.6% in 56 cadavers (10) and in Spanish population it is reported as 3% from a study of 50 cadavers (11) . This indicate that incidence of Axillary arch varies in different countries though the incidence is unknown in Indians.…”

Axillary arch: Clinical significance in breast cancer patients

“…The prevalence of axillary arch in cadaveric dissection in Japanese, Turkish and Bulgarian populations is 9.1%, 1.9% and 3.6% respectively [5][6][7]. On the other hand, it has been recognized in only 0.25% of patients during axillary surgical procedures [8].…”

The Existence of Axillary Arch in Human Fetus and Applied Importance and Clinical Implications in the Axillary Brachial Plexus Blocks

“…Among the other pathologies that AA brought about, hyperabduction syndrome (Mérida-Velasco et al ;Georgiev et al;Rizk & Harbaugh, 2008) thoracic outlet syndrome (Georgiev et al; Rizk & Harbaugh) shoulder instability syndrome (Petrasek et al, 1997) and thrombosis of upper extremity (Turgut et al, 2005) have been reported. So, during preoperative evaluation for axillary block, the chronic pain of the arm should be investigated.…”

“…The most common variation of axilla is the axillary arch (AA) (Daniels & della Rovere, 2000;Besana-Ciani & Greenall, 2005;Georgiev et al, 2007;Millet et al, 2007). Axillary arch may be an extension of the muscle bundle of latissimus dorsi (Miguel et al, 2001;Mérida-Velasco et al, 2003;Georgiev et al), but may also commence by a tendon at the lateral side of the muscle (Mérida-Velasco et al). Typical AA commences from the anterior (or lateral) edge of latissimus dorsi and by passing over the neurovascular bundle it inserts pectoralis major tendon (Natsis et al, 2010).…”