REVIEW  EXERCISE AND SPORT CARDIOLOGY 

The Journal of Sports Medicine and Physical Fitness 2019 June;59(6):1058-67

DOI: 10.23736/S0022-4707.18.08579-1

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

A systematic review on posterior circumflex humeral artery pathology: sports and professions at risk and associated risk factors

Rik B. KRAAN ^{1, 2} ✉, Lisa BEERS ³, Daan van de POL ^{2, 4}, Joost G. DAAMS ⁵, Mario MAAS ^{1, 2}, P. Paul KUIJER ³

¹ Department of Radiology and Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; ² Academic Center for Evidence based Sports Medicine (ACES), Amsterdam, the Netherlands; ³ Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; ⁴ Department of Sports Medicine, The Hague Medical Center, The Hague, the Netherlands; ⁵ Medical Library, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands

INTRODUCTION: Posterior circumflex humeral artery (PCHA) aneurysm formation and thrombosis as overuse injury in the dominant shoulder can result in ischemia of the forearm, hand and digits due to arterial embolisms. Increased awareness among physicians is necessary as PCHA pathology (PCHAP) might be underdiagnosed. Knowledge of sports and professions at risk and risk-factors for obtaining PCHAP is essential for the development of future preventive measures. This study aims to identify sports and professions at risk as well as risk factors for PCHAP.
EVIDENCE ACQUISITION: The databases of MEDLINE, EMBASE, BIOSIS, CINAHL and SPORTDiscus were systematically searched.
EVIDENCE SYNTHESIS: Twenty-seven papers fulfilled the inclusion criteria and described 67 patients with PCHAP involved in seven sports and three professions. The sports (number of cases) were volleyball (41), baseball (13), swimming (1), tennis (3), American football (2), canoeing (1) and yoga (1) (2 unknown). The professions included a baseball coach, a circus trapeze artist and a mechanic. Apart from expert opinions, no studies have identified risk factors for PCHAP. An anatomic variation of the PCHA origin is suggested to be protective for PCHAP.
CONCLUSIONS: PCHAP is reported in seven overhead sports and three professions. No risk factors for PCHAP were identified. An anatomic variant of the PCHA origin was found to be a potential protective factor for PCHAP. Physicians should be cautious for distal embolization as a result of PCHAP in athletes and workers, both adult and adolescent, involved in repetitive powerful overhead movements.

KEY WORDS: Vascular system injuries; Athletes; Shoulder injuries; Embolism; Thrombosis