Case Report: A Case Report on Variation in Bifurcation of Brachial Artery

Variations in arterial anatomy are less frequent, contrary to the venous system, and most of these variations affect visceral arteries. Variations in the brachial artery are the most frequently reported and so far a minimum of six different patterns have been described. The most common of these patterns is the superficial brachial artery, which lies superficially to the median nerve. Much less prevalent is the high origin of the radial artery (brachioradial artery) or the existence of a doubled brachial artery (accessory brachial artery). The current study presents a pattern of brachial artery variation which was previously undescribed. During dissection of the right upper limb of a 50 year-old male embalmed cadaver, the bifurcation of the brachial artery in the proximal portion of the middle third of the arm was observed. In this case, the medial branch reaches the medial aspect of the arm, posterior to the median nerve. Afterwards, this medial branch redirects laterally and crosses the median nerve again, this time lying anterior to the nerve till it reaches the lateral aspect of the arm. At the elbow level, the medial branch originates from the radial artery. The lateral branch of the brachial artery remains lateral to the median nerve and continues as ulnar artery and originates from the interosseous artery. It was also observed that the left brachial artery was smaller in size, and bifurcated high in the arm into the superficial radial and ulnar arteries. It was also interesting to note that the common interosseous artery was originated from the left radial artery in the cubital fossa, which descended deep to pronator teres where it was divided into the anterior and posterior interosseous arteries. These variations are discussed comprehensively and compared with the previous reports. Also, it is asserted how clinically the findings are significant.