45 year-old woman with history of trauma

 

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Doctor's Information

Name : Morteza
Family :Sanei Taheri
Affiliation : Radiology Department,Shohada Tajrish Hospital,SBMU
Academic Degree: Associate Professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Pooneh Tayari

 

Case Section

Cardiovascular

 

Patient's Information

Gender : Female
Age : 45

 

Clinical Summary

45 year-old woman with history of trauma

 

 

Imaging Findings

CT angiography and corresponding volume-rendered images show that the left subclavian artery bifurcates into two axillary arteries; the main and the accessory one. Similarely, the axillary arteries constitute the corresponding brachial arteries; the main and the accessory one. Main brachial artery bifurcates into interosseous artery and radial artery; whereas, accessory brachial artery makes the ulnar artery. A hyperdense area is seen in left axillary region, in favor of hematoma.

 

Differential Diagnosis

None

 

Final Diagnosis

unilateral double axillary and brachial arteries

 

Discussion (Related Text)

Anatomic variations in the major arteries of the upper limb have been reported.The increasing use of invasive diagnostic and interventional procedures in cardiovascular diseases makes it important that the type and frequency of vascular variations are well documented and understood. Branches of the upper limb arteries have been used for coronary bypass and flaps in reconstructive surgery. Accurate knowledge of the normal and variant arterial pattern of the human upper extremities is important both for reparative surgery and for angiography.Axillary artery is the direct continuation of the subclavian artery from the outer border of the first rib. The course of the axillary artery is anatomically divided into three parts by the pectoralis minor muscle. The first part begins at the lateral border of the first rib and extends to the medial border of the pectoralis minor muscle. The first part is enclosed within the axillary sheath along with the axillary vein and brachial plexus. The second part of the axillary artery lies deep to the pectoralis minor muscle. The third part lies between the lateral border of the pectoralis minor muscle and the inferior border of the teres major muscle. The axillary artery is usually described as giving off six branches. The first part of the artery gives superior thoracic artery. The second part of the artery gives lateral thoracic and thoracoacromial branches. The third part of the artery gives subscapular artery, anterior circumflex humeral and posterior circumflex humeral arteries.

 

References

1.Rao TR, Shetty P, Suresh R. Abnormal Branching Pattern of the Axillary Artery and its Clinical Significance. Int. J. Morphol. 2008; 26(2):389-392.

2.Samuel VP, Vollala VR, Nayak S, Rao M, Bolla SR, Pammidi N. A rare variation in the branching pattern of the axillary artery. Indian J Plast Surg 2006;39:222-3.

 

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