Arterial Anatomy of the Shoulder: What the Interventional Radiologist Needs to Know

Adhesive capsulitis (AC) is a common cause of chronic shoulder pain for which transcatheter arterial embolization (TAE) is emerging as a minimally invasive therapy. This intervention targets neovascularization associated with chronic inflammation in AC. This review aims to summarize the vascular anatomy of the shoulder relevant to embolization. We report on data from cadaveric, diagnostic imaging, and embolization studies evaluating axillary artery branches, their variants, and angiographic blush patterns in AC embolization. The shoulder's arterial supply arises primarily from the axillary artery and thyrocervical trunk, which form extensive anastomoses. Angiographic studies of patients undergoing TAE demonstrate a hyper vascular blush in symptomatic regions and include characterization of the arterial branches perfusing these regions. Detailed knowledge of the vascular anatomy of the shoulder and its variants is valuable to understand, so as to perform TAE in a safe and effective manner.