A rare case of atypical thoracodorsal artery: a challenge for flap reconstruction

The thoracodorsal artery mainly supplies the latissimus dorsi muscle. Anatomical details pertaining to the origin and distribution of thoracodorsal artery are important because the latissimus dorsi myocutaneous flap is one of the most reliable and versatile flaps used in reconstructive surgery. Atypical origin and course of the thoracodorsal artery is, therefore, a challenge for flap reconstruction surgeries. In the present case, we report multiple variations in the branching pattern of axillary artery. The thoracodorsal artery had an unusual origin from the second part of axillary artery. The trunk of thoracoacromial artery was absent. The thoracodorsal artery after its origin, descended downwards over the lateral pectoral region lying deep to pectoralis minor but superficial to teres major muscles. It terminated by supplying the latissimus dorsi muscle. Due to the presence of atypical thoracodorsal branch, the subscapular artery continued as the circumflex scapular artery.