The origin of the dorsal scapular artery: anatomic variations and surgical applications

Abstract

The dorsal scapular artery (DSA) can be either a direct branch of the subclavian artery (SCA), or a branch of the transverse cervical artery (TCA). In mandibular reconstruction, when a free flap is contraindicated a pedicled scapular flap has been described vascularized by the DSA. During the dissection of this flap, there is a risk of lesion of the TCA, which could be fatal to the flap if the DCA is a branch of the TCA. To evaluate the frequency of this anatomic situation, a dissection and radiologic study has been performed. 50 anatomic dissections on fresh cadavers and 93 arteriographies from 47 patients have been studied, to determine what was the DSA origin. In our dissections we found the origin of the DSA was a type I origin in 19 cases (38 %), a type II in 19 cases (38 %) and a type III in 12 cases (24 %). In our radiologic study, the DSA and the TCA had a common origin from the SCA (Type I) in 57/93 cases (61.3 %), the DSA was a direct branch of the SCA and the TCA (type II) in 22/93 cases (23.7 %), the DSA and the TCA had a common origin from the TCT (type III) in 14/93 cases (15 %). The DSA is coming from the TCA in 1/5 cases. A careful dissection of this flap in the subclavian area is necessary in all cases, a preoperative arteriography could be proposed to limit the risk of pedicle injury.

Dorsal scapular artery as a recipient vessel in the vessel‐depleted neck during free tissue transfer in head and neck reconstruction

“…Additionally, in a proportion of patients, the dorsal scapular artery may arise from the transverse cervical vessel. This is reported in up to one third of cases, and, in these patients, the vessel may have been damaged during a previous neck dissection . Preoperative imaging with a contrasted CT scan, however, should help to delineate the vessel and ensure flow when considering these cases.…”

“…This is reported in up to one third of cases, and, in these patients, the vessel may have been damaged during a previous neck dissection. 17,18 Preoperative imaging with a contrasted CT scan, however, should help to delineate the vessel and ensure flow when considering these cases. The relationship of the dorsal scapular artery to the brachial plexus can be variable.…”

Arterial Variations Within the Lateral Cervical Region: A Multidetector CT Angiography Study

“…Gao et al (2016) evaluated thoracic branch of SSA with CDUS before flap operation, however they did not interested in other arteries. Ikka et al (2016) evaluated the origin of DScA in fresh cadavers and digital subtraction angiographies. They did not report the origins of other arteries within the lateral cervical region.…”

Anatomical variations on the origin of the dorsal scarular artery: about 58 dissections

“…In this case its origin is localized below the anterior scalene muscle (scalenus anterior). 1 Some authors describe this artery as the deep branch of the arteria transversa cervicis, arising next to the anterior edge of the trapezius muscle. 1 Irrespective of its origin, the arteria dorsalis scapulae represents the main vascular pedicle of the trapezius muscle and surrounding integuments.…”

“…1 Some authors describe this artery as the deep branch of the arteria transversa cervicis, arising next to the anterior edge of the trapezius muscle. 1 Irrespective of its origin, the arteria dorsalis scapulae represents the main vascular pedicle of the trapezius muscle and surrounding integuments. Any microvascular surgery in the trapezian region therefore implies an excellent knowledge of the anatomy of the arteria dorsalis scapulae whose origin -and therefore the path -can be very variable.…”