Abstract
Shoulder Arthroscopy techniques may pose surgical risk to vascular structures that may cause active bleeding during surgery. The vascularity of the subacromial structures showed constant patterns of distribution and specific sources of bleeding were analyzed. Knowledge of the vascular anatomy may decrease the bleeding during subacromial arthroscopy surgery.
Shoulder Arthroscopy techniques may pose surgical risk to vascular structures that may cause active bleeding during surgery. A detailed anatomy map of frequent sources of bleeding is more than desired in order to properly identify these bleeding points, and avoid the unnecessary overuse of thermal tools and pressure pumps to control the hemorrhage.
Our purpose is to study the vascular anatomy of the subacromial space, and to map the major sources of expected bleeding during subacromial arthroscopy surgery.
Ten shoulders of five adult cadavers underwent whole body arterial perfusion with a mixture of lead oxide, gelatin and water. The shoulders were dissected, photographed, tissue specimens were radio graphed, scanned and analyzed with a digital software analyzer. Careful dissection of the different arteries of the subacromial bursa, and anatomic landmarks of the walls were documented. Correlations of bleeding areas during subacromial arthroscopic surgery and cadaver dissection were carried out. A vascular map of the bursa was created.
The vascularity of the subacromial structures showed constant patterns of distribution and specific sources of bleeding were analyzed. We divided this space into walls with their major arteries as follows: Anterior wall: Acromial branch of the thoracoacromial artery. Posterior wall: Acromial branch of the suprascapular artery. Medial wall: Anterior and posterior Arteries of the AC joint. Lateral wall: No major arteries identified. Vascularity of the roof and floor is also described.
The subacromial space is highly vascular. Knowledge of the vascular anatomy may decrease the bleeding during subacromial arthroscopy surgery.
Correspondence should be addressed to Cynthia Vezina, Communications Manager, COA, 4150-360 Ste. Catherine St. West, Westmount, QC H3Z 2Y5, Canada
