Skip to main content
SpringerLink
Log in

Angiographic Analysis of Anatomical Variants in Adhesive Capsulitis Embolization

  • Technical note
  • Embolisation (arterial)
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To analyze the complex shoulder vasculature and identify potential challenges during adhesive capsulitis embolization (ACE).

Materials and Methods

Two interventional radiologists evaluated angiographic findings from 21 ACE procedures. The suprascapular artery (SSA), thoracoacromial artery (TAA), coracoid branch (CB), circumflex scapular artery (CSA), and anterior/posterior circumflex humeral artery (ACHA/PCHA) were assessed for their presence, course, diameter within 1 cm of origin, angle to the proximal parent vessel, and distance from the clavicle.

Results

83 arteries were embolized: CB (20.5%), TAA (19.3%), PCHA (19.3%), ACHA (16.9%), CSA (14.5%), and SSA (9.6%). The CSA had the largest diameter (4.3 mm), while CB had the smallest diameter (1.0 mm). An acute angle to the parent vessel was noted with the SSA, TAA, ACHA, and PCHA. A common origin for CSA and PCHA was noted in 2 patients. A common origin for TAA and SSA was also noted in one patient. The CB appears perpendicular to the axillary artery and courses vertically toward the coracoid process. The TAA branches off the axillary artery and courses along the medial border of the pectoralis minor. The PCHA and ACHA originate from the axillary artery. The CSA is located on the medial side of axillary artery. The SSA originates from the thyrocervical trunk and courses laterally toward the superior border of the scapula.

Conclusion

An anatomical-technical guide is provided to help interventional radiologists during ACE to treat adhesive capsulitis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig.6
Fig. 7

References

  1. Okuno Y, et al. Short-term results of transcatheter arterial embolization for abnormal neovessels in patients with adhesive capsulitis: a pilot study. J Shoulder Elbow Surg. 2014;23(9):e199-206.

    Article  PubMed  Google Scholar 

  2. Okuno Y, et al. Clinical outcomes of transcatheter arterial embolization for adhesive capsulitis resistant to conservative treatment. J Vasc Interv Radiol. 2017;28(2):161-167.e1.

    Article  PubMed  Google Scholar 

  3. Hwang JH, et al. Early results of transcatheter arterial embolization for relief of chronic shoulder or elbow pain associated with tendinopathy refractory to conservative treatment. J Vasc Interv Radiol. 2018;29(4):510–7.

    Article  PubMed  Google Scholar 

  4. Maslarski I. The artery blood supply variant of the upper limb. Clujul Med. 2015;88(4):545–9.

    PubMed  PubMed Central  Google Scholar 

  5. Pandey SK, et al. Anatomical variations in termination of the axillary artery and its clinical implications. Med Sci Law. 2004;44(1):61–6.

    Article  CAS  PubMed  Google Scholar 

  6. Okuno Y, Yasumoto T, Koganemaru M, Suyama Y, Nishiofuku H, Horikawa M, Komemushi A. Transcatheter arterial embolization of neovascularity for refractory nighttime shoulder pain: a multicenter, open-label, feasibility trial. J Vasc Interv Radiol. 2022;33:1468.

    Article  PubMed  Google Scholar 

  7. Hattori Y, et al. Anatomic variations in branching patterns of the axillary artery: a multidetector-row computed tomography angiography study. J Reconstr Microsurg. 2013;29(8):531–6.

    Article  PubMed  Google Scholar 

  8. Pyrgakis P, Panagouli E, Venieratos D. Anomalous origin and course of the suprascapular artery combined with absence of the suprascapular vein: case study and clinical implications. N Am J Med Sci. 2013;5(2):129–33.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Bagla S, et al. Results from a United States investigational device study of adhesive capsulitis embolization in the treatment of shoulder pain: the adhesive capsulitis embolization study. J Vasc Interv Radiol. 2022;33(2):177–82.

    Article  PubMed  Google Scholar 

  10. Singh R. Variations in the origin and course of the suprascapular artery: case report and literature review. J Vasc Bras. 2018;17(1):61–5.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Pandey SK, Shukla VK. Anatomical variation in origin and course of the thoracoacromial trunk and its branches. Nepal Med Coll J. 2004;6(2):88–91.

    PubMed  Google Scholar 

  12. Khundkar R, Giele H. The coracoid process is supplied by a direct branch of the 2nd part of the axillary artery permitting use of the coracoid as a vascularised bone flap, and improving it’s viability in Latarjet or Bristow procedures. J Plast Reconstr Aesthet Surg. 2019;72(4):609–15.

    Article  CAS  PubMed  Google Scholar 

  13. Garry, N.E. and S. Marquez, The Subscapular Artery in the Axillary Region: Tracking its Anatomical Distribution for Clinical Application. The FASEB Journal, 2008. 22(1_supplement): p. 586.5–586.5.

  14. Jesus RC, et al. The subscapular artery and the thoracodorsal branch: an anatomical study. Folia Morphol (Warsz). 2008;67(1):58–62.

    CAS  PubMed  Google Scholar 

Download references

Funding

This study was funded by Terumo Medical (Somerset, NJ).

Author information

Authors and Affiliations

  1. Prostate Centers USA, 1801 Robert Fulton Dr Suite 510, Reston, VA, 20191, USA

    Rachel Piechowiak DO

  2. Columbia University Irving Medical Center, 622 W 168th St, New York, NY, 10032, USA

    Abin Sajan MD

  3. Prostate Centers USA, 9400 Brier Creek Pkwy Suite 202, Raleigh, NC, 27617, USA

    Ari Isaacson MD

  4. St George’s University School of Medicine, University Centre Grenada, West Indies, Grenada

    Jade Lerner MD

  5. Prostate Centers USA, 2755 Hartland Rd #110, Falls Church, VA, 22043, USA

    Sandeep Bagla MD

Authors
  1. Rachel Piechowiak DO
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Abin Sajan MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ari Isaacson MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jade Lerner MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sandeep Bagla MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jade Lerner MD.

Ethics declarations

Conflict of interest

Ari Isaacson: Consulting fees (Boston Scientific, CrannMed); Payment (Terumo, Guerbet); Participation on a Data Safety Monitoring Board (Boston Scientific). Sandeep Bagla: Consulting fees (Medtronic, CrannMed, Boston Scientific, Terumo, Guerbet, Varian); Leadership (President & CEO Prostate Centers USA); Stock (MBiotechnologies, Embolx).

Ethical Approval

Institutional IRB approval was provided by The Western Institutional Review Board—protocol number: 20181853) and received an Investigational Device Exemption (IDE NCT03676829) from the U.S. Food and Drug Administration.

Consent for Publication

For this type of study, consent for publication is not required.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Piechowiak, R., Sajan, A., Isaacson, A. et al. Angiographic Analysis of Anatomical Variants in Adhesive Capsulitis Embolization. Cardiovasc Intervent Radiol 46, 799–804 (2023). https://doi.org/10.1007/s00270-023-03427-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-023-03427-9

Keywords

Search

Navigation