The circumflex scapular artery arises from the subscapular artery and passes through the triangular space (bounded by teres major, teres minor, and the long head of triceps) to divide into cutaneous and deep branches on the posterior scapular surface. It is the dominant vessel of the parascapular and scapular fasciocutaneous flaps used in reconstructive surgery.
The circumflex scapular artery is the pedicle for the parascapular flap, scapular flap, and chimeric scapular-latissimus flaps used for complex reconstructive procedures. Its course through the triangular space is the anatomical basis for scapular artery angiography in suspected quadrilateral space syndrome. The triangular space through which it passes is distinct from the quadrilateral space (transmitting the posterior circumflex humeral artery) and the triangular interval (transmitting the radial nerve). Doppler mapping before flap elevation confirms patency.
Entrapment of the circumflex scapular artery in the triangular space producing posterior shoulder aching and scapular region numbness, distinguishable from quadrilateral space syndrome by its medial location and absence of deltoid or teres minor involvement.
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