Anatomical study of the clavicular branch of the thoracoacromial artery

Introduction: The etiology and the complexity of losses of substances from the chest wall cause technical difficulties during their reconstruction. In order to obtain the best possible functional and morphological results, it is important to appreciate the lesions. When considering soft tissue reconstruction, the dimensions, location and shape of losses of substances, as well as the reliability and the arc of rotation of the chosen flap, must be taken into account. The perforator flap of the thoracoacromial artery and its vascular anatomical bases have been recently studied, concerning the pectoral and deltoid branches. The clavicular branch has only been rarely studied. We propose to study anatomically the clavicular branch of the thoracoacromial artery, in terms of constancy, dimensions and direction, in order to give to practitioners an additional option in the surgery of perforator flaps of the cervical region. Material and methods: We carried out a direct and selective injection of 24 thoracoacromial arteries, on corpses preserved in a low-formalin solution rich in glycerin. The injected solution was made from a mixture of methylene blue and gelatin. Cadaveric dissection was then used to study the location, frequency, and path of the clavicular branch of the thoracoacromial artery. Results: The clavicular branch was absent in more than half of the dissections. The length of its extrafascial pedicle varied between 0.5 and 2.5cm. The length of the pedicle after transmuscular dissection varied between 3 and 6cm. The general direction of this clavicular branch was ascending and medial. Conclusion: Our work shows that when it is present the clavicular branch of the thoracoacromial artery has an extrafascial pedicle which measures 0.5 to 2.5cm, and a transmuscular pedicle from 3 to 6cm. And that its vascular skin territory projects slightly below the clavicle.