Origin-order classification of axillary third-part branching: Donor-based dissection–CTA correlation for surgical planning

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dc.authorid0000-0001-7048-036X
dc.authorid0000-0002-0337-4927
dc.authorid0000-0001-9188-4662
dc.authorid0000-0001-7958-3170
dc.authorid0000-0003-4270-6370
dc.authorid0000-0002-5819-0543
dc.authorid0000-0002-2305-420X
dc.contributor.authorTemizsoy Korkmaz, Fulya
dc.contributor.authorCoşkun, Osman
dc.contributor.authorGürses, İlke Ali
dc.contributor.authorGayretli, Özcan
dc.contributor.authorÖzdemir, Sevim
dc.contributor.authorÖztürk, Adnan
dc.contributor.authorKale, Ayşin
dc.date.accessioned2025-11-20T09:03:21Z
dc.date.available2025-11-20T09:03:21Z
dc.date.issued2025
dc.departmentFakülteler, Tıp Fakültesi, Temel Tıp Bilimleri Bölümü, Anatomi Ana Bilim Dalı
dc.description.abstractPurpose Variations in the branching of the subscapular artery (SSA), anterior circumflex humeral artery (ACHA), and posterior circumflex humeral artery (PCHA) are directly relevant to reconstructive planning with subscapular-system flaps and to humeral-head perfusion in shoulder surgery. Evidence organized around an origin-order–based framework remains limited. We aimed to address this gap by comparing body-donor dissections and computed tomography angiography (CTA) to provide a clinically useful classification and morphometric reference. Methods We performed a two-arm cross-sectional morphometric study: body-donor dissection (28 donors; bilateral, 56 sides) and CTA (25 patients; bilateral, 50 sides). In total, 104 sides were evaluated; 96 were classifiable. Classification used the sequential SSA–ACHA–PCHA origin order and common-trunk presence. Ostial diameters and SSA → CSA distances were measured; the radial nerve (NR)–SSA relationship was assessed in donors. origin_order__five_type_classif… Results In donors, Type-1, -2, -3, and -4 accounted for 36.5%, 32.7%, 23.1%, and 7.7%, respectively; Type-5 was absent. In CTA, Type-1, -4, and -5 comprised 93.2%, 2.3%, and 4.5% (one bilateral case); Types-2/-3 were not observed. Inter-modality comparison showed a longer SSA → CSA distance and smaller TDA/CSA diameters in CTA (all p < 0.001), while the SSA ostial diameter was similar. A posterior NR course relative to the SSA was associated with a longer SSA → CSA distance (p = 0.026). Conclusion An origin-order–based classification, corroborated across dissection and CTA, yields a practical map for (i) single-pedicle harvesting within the subscapular system and chimeric flap design, and (ii) avoiding iatrogenic compromise of humeral-head vascularity during shoulder procedures. Incorporating presurgical CTA mapping of the SSA and its branches may enhance safety where variants (e.g., short/combined trunks, rare Type-5) are suspected.
dc.identifier.citationTemizsoy Korkmaz, F., Coşkun, O., Gürses, İ. A., Gayretli, Ö., Özdemir, S., Öztürk, A., & Kale, A. (2025). Origin-order classification of axillary third-part branching: Donor-based dissection–CTA correlation for surgical planning. Bratislava Medical Journal, https://doi.org/10.1007/s44411-025-00393-1
dc.identifier.doi10.1007/s44411-025-00393-1
dc.identifier.issn1336-0345
dc.identifier.scopusqualityQ2
dc.identifier.urihttps://doi.org/10.1007/s44411-025-00393-1
dc.identifier.urihttps://hdl.handle.net/20.500.13055/1191
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.indekslendigikaynak.otherSCI-E - Science Citation Index Expanded
dc.institutionauthorÖztürk, Adnan
dc.institutionauthorid0000-0002-5819-0543
dc.language.isoen
dc.publisherSpringer Nature Link
dc.relation.ispartofBratislava Medical Journal
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectAxillary Artery
dc.subjectSubscapular Artery (SSA)
dc.subjectAnterior Circumflex Humeral Artery (ACHA)
dc.subjectPosterior Circumflex Humeral Artery (PCHA)
dc.subjectComputed Tomography Angiography (CTA)
dc.subjectBody-Donor Dissection
dc.subjectReconstructive Surgery
dc.subjectShoulder Surgery
dc.titleOrigin-order classification of axillary third-part branching: Donor-based dissection–CTA correlation for surgical planning
dc.typeArticle
dspace.entity.typePublication

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