Brachial artery variation: a rare pattern

ABSTRACT

Unlike venous system, variations in arterial anatomy are less frequent and most of them affect visceral arteries.In limbs, variations of the brachial artery are the most reported and at least six different patterns have beendescribed so far. The commonest is the superficial brachial artery, which lies superficially to the median nerve.Much less prevalent are the high origin of the radial artery (brachioradial artery) or the existence of a doubledbrachial artery (accessory brachial artery). We present a previously undescribed pattern of brachial arteryvariation. During dissection of the right upper limb of a 60-year-old male embalmed cadaver, we found thebifurcation of the brachial artery in the proximal portion of the middle third of the arm. Its medial branchreaches the medial aspect of the arm, posterior to the median nerve. Afterwards, this medial branch redirectslaterally and crosses again the median nerve, this time lying anterior to the nerve until it reaches the lateralaspect of the arm. At the elbow level, the medial branch originates the radial artery. The lateral branch of thebrachial artery remains lateral to the median nerve, continues as ulnar artery, and originates the interosseusartery.