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During dissection conducted in an anatomy department of the right upper limb of the cadaver of a 70-year-old male, both origin and course of the radial and ulnar arteries were found to be anomalous. After descending 5.5 cm from the lower border of the teres major, the brachial artery anomalously bifurcated into a radial artery medially and an ulnar artery laterally. In the arm, the ulnar artery lay lateral to the median nerve. It followed a normal course in the forearm. The radial artery was medial to the median nerve in the arm and then, at the level of the medial epicondyle, it crossed from the medial to the lateral side of the forearm, superficial to the flexor muscles. The course of the radial artery was superficial and tortuous throughout the arm and forearm. The variations of radial and ulnar arteries described above were associated with anomalous formation and course of the median nerve in the arm. Knowledge of neurovascular anomalies are important for vascular surgeons and radiologists. [ABSTRACT FROM AUTHOR]

BACKGROUND: Variations in the branching pattern of the axillary artery are a rule rather than an exception. The knowledge of these variations is of anatomical, radiological, and surgical interest to explain unexpected clinical signs and symptoms. OBJECTIVE: The large percentage of variations in branching pattern of axillary artery is making it worthwhile to take any anomaly into consideration. The type and frequency of these vascular variations should be well understood and documented, as increasing performance of coronary artery bypass surgery and other cardiovascular surgical procedures. The objective of this study is to observe variations in axillary artery branches in human cadavers. METHODS: We dissected 80 limbs of 40 human adult embalmed cadavers of Asian origin and we have studied the branching patterns of the axillary artery. RESULTS: We found variations in branching pattern of axillary artery in 62.5% of the limbs. Anatomical variations included: origin of lateral thoracic artery from the subscapular artery; absent thoracoacromial trunk and all its branches arose directly from the second part of the axillary artery; division of thoracoacromial trunk into deltoacromial and clavipectoral trunks, which were divided into all branches of thoracoacromial trunk; origin of subscapular, anterior circumflex humeral, posterior circumflex humeral and profunda brachii arteries from a common trunk from the third part of the axillary artery; and origin of posterior circumflex humeral artery from brachial artery in addition to third part of the axillary artery. CONCLUSIONS: The study was carried out to show important variations in the branching pattern of axillary artery, in order to orient the surgeons performing angiography, coronary bypass, and flaps in reconstructive surgeries.CONTEXTO: As variações no teste padrão de ramificação da artéria axilar são preferencialmente uma regra do que uma exceção. O conhecimento destas variações é de interesse anatômico, radiológico e cirúrgico para explicar os sinais e sintomas clínicos inesperados. OBJETIVO: O grande percentual de variações no padrão de ramificação da artéria axilar deve ser levado em consideração. O uso crescente de procedimentos invasores e intervencionistas em procedimentos cirúrgicos cardiovasculares e em cirurgias reconstrutivas da região axilar faz com que seja mais importante que o tipo e a frequência destas variações vasculares sejam entendidos e documentados. MÉTODOS: Oitenta membros de 40 cadáveres adultos embalsamados de origem asiática foram dissecados, e os testes padrões de ramificação da artéria axilar foram estudados. RESULTADOS: Foram encontradas variações no padrão de ramificação da artéria axilar em 62,5% dos membros. Variações anatômicas incluíram: origem da artéria torácica lateral da artéria subescapular; tronco toracoacromial ausente e todos os ramos surgiram diretamente a partir da segunda parte da artéria axilar; divisão do tronco toracoacromial em troncos deltoacromial e clavipeitoral, que foram divididos em todos os ramos do tronco toracoacromial; origem do subescapular umeral circunflexo anterior, umeral circunflexo posterior e artérias braquiais profundas a partir de um tronco comum da terceira parte da artéria axilar; e origem da artéria umeral circunflexa posterior da artéria braquial, além de terceira parte da artéria axilar. CONCLUSÕES: O estudo foi realizado para mostrar as importantes variações no teste padrão de ramificação da artéria axilar para orientar os cirurgiões que realizam angiografias, pontes de safena e retalhos em cirurgias reconstrutivas.

Abstract During dissection conducted in an anatomy department of the right upper limb of the cadaver of a 70-year-old male, both origin and course of the radial and ulnar arteries were found to be anomalous. After descending 5.5 cm from the lower border of the teres major, the brachial artery anomalously bifurcated into a radial artery medially and an ulnar artery laterally. In the arm, the ulnar artery lay lateral to the median nerve. It followed a normal course in the forearm. The radial artery was medial to the median nerve in the arm and then, at the level of the medial epicondyle, it crossed from the medial to the lateral side of the forearm, superficial to the flexor muscles. The course of the radial artery was superficial and tortuous throughout the arm and forearm. The variations of radial and ulnar arteries described above were associated with anomalous formation and course of the median nerve in the arm. Knowledge of neurovascular anomalies are important for vascular surgeons and radiologists.