open access

Vol 82, No 4 (2023)
Case report
Submitted: 2023-02-08
Accepted: 2023-03-12
Published online: 2023-04-03
Get Citation

Bilateral absence of the deep brachial artery

W. Przybycień1, M. Bonczar12, P. Ostrowski12, K. Możdżeń1, A. Murawska1, A. Gil1, K. Balawender3, J. Walocha12, M. Koziej12
·
Pubmed: 37016782
·
Folia Morphol 2023;82(4):948-952.
Affiliations
  1. Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
  2. Youthoria, Youth Research Organization, Krakow, Poland
  3. Department of Normal and Clinical Anatomy, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland

open access

Vol 82, No 4 (2023)
CASE REPORTS
Submitted: 2023-02-08
Accepted: 2023-03-12
Published online: 2023-04-03

Abstract

The aim of the following study was to present and comprehensively describe
a case of a bilateral absence of the deep brachial artery (DBA). Furthermore, its
embryology and clinical significance will also be discussed.
During routine dissection, a 71-year-old male cadaver with a bilateral abnormality
in the DBA and its branches was found. The first branch of the brachial artery (BA)
was found to be the radial collateral artery, which passed behind the radial nerve.
Furthermore, the middle collateral artery originated distal to the radial collateral
artery and gave off first a singular, minor muscular branch and then the superior
ulnar collateral artery. Later, the preceding nutrient arteries of the humerus and
the deltoid branch consecutively branched off from the middle collateral artery.
Subsequently, the middle ulnar collateral artery, the inferior ulnar collateral artery,
the deltoid artery, the radial artery, and the ulnar artery branched off from the
BA, as adapted in the current knowledge regarding the anatomy of the upper
extremity. Furthermore, detailed measurements of the distances between the
mentioned arteries were carried out.
In the present study, a bilateral absence of the DBA was demonstrated. Meta-analysis
focusing on the anatomy of this artery has shown how variable its characteristics
are. However, our case report is the first in the literature to present this extremely
rare variation. Having adequate knowledge regarding the anatomy of the arteries
of the proximal arm is of immense importance when performing orthopaedic
and reconstructive surgeries in this area.

Abstract

The aim of the following study was to present and comprehensively describe
a case of a bilateral absence of the deep brachial artery (DBA). Furthermore, its
embryology and clinical significance will also be discussed.
During routine dissection, a 71-year-old male cadaver with a bilateral abnormality
in the DBA and its branches was found. The first branch of the brachial artery (BA)
was found to be the radial collateral artery, which passed behind the radial nerve.
Furthermore, the middle collateral artery originated distal to the radial collateral
artery and gave off first a singular, minor muscular branch and then the superior
ulnar collateral artery. Later, the preceding nutrient arteries of the humerus and
the deltoid branch consecutively branched off from the middle collateral artery.
Subsequently, the middle ulnar collateral artery, the inferior ulnar collateral artery,
the deltoid artery, the radial artery, and the ulnar artery branched off from the
BA, as adapted in the current knowledge regarding the anatomy of the upper
extremity. Furthermore, detailed measurements of the distances between the
mentioned arteries were carried out.
In the present study, a bilateral absence of the DBA was demonstrated. Meta-analysis
focusing on the anatomy of this artery has shown how variable its characteristics
are. However, our case report is the first in the literature to present this extremely
rare variation. Having adequate knowledge regarding the anatomy of the arteries
of the proximal arm is of immense importance when performing orthopaedic
and reconstructive surgeries in this area.

Get Citation

Keywords

deep brachial artery, arm, upper limb, anatomy, embryology

About this article
Title

Bilateral absence of the deep brachial artery

Journal

Folia Morphologica

Issue

Vol 82, No 4 (2023)

Article type

Case report

Pages

948-952

Published online

2023-04-03

Page views

685

Article views/downloads

507

DOI

10.5603/FM.a2023.0026

Pubmed

37016782

Bibliographic record

Folia Morphol 2023;82(4):948-952.

Keywords

deep brachial artery
arm
upper limb
anatomy
embryology

Authors

W. Przybycień
M. Bonczar
P. Ostrowski
K. Możdżeń
A. Murawska
A. Gil
K. Balawender
J. Walocha
M. Koziej

References (18)
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  2. Charles CM, Penn L, Holden HF, et al. The origin of the deep brachial artery in American white and in American negro males. Anat Rec. 1931; 50(3): 299–302.
  3. Ciervo A, Kahn M, Pangilinan AJ, et al. Absence of the brachial artery: report of a rare human variation and review of upper extremity arterial anomalies. J Vasc Surg. 2001; 33(1): 191–194.
  4. Clarke E, Mazurek A, Radek M, et al. Superficial brachial artery: a case report with commentaries on the classification. Transl Res Anat. 2021; 23: 100112.
  5. Clarke E, Olszewska A, Zarzecki M, et al. Case report of the brachial artery trifurcation: An anatomical study and concise literature review. Transl Res Anat. 2022; 27: 100198.
  6. Ekim H, Tuncer M. Management of traumatic brachial artery injuries: a report on 49 patients. Ann Saudi Med. 2009; 29(2): 105–109.
  7. Grechenig S, Hohenberger G, Bakota B, et al. Humeral shaft cerclage wiring: a safe technique to prevent radial nerve injury. Injury. 2017; 48 Suppl 5: S12–S14.
  8. Iwanaga J, Singh V, Takeda S, et al. Acknowledging the use of human cadaveric tissues in research papers: Recommendations from anatomical journal editors. Clin Anat. 2021; 34(1): 2–4.
  9. McCready RA. Upper-extremity vascular injuries. Surg Clin North Am. 1988; 68(4): 725–740.
  10. Meirer R, Schrank C, Putz R. Posterior radial collateral artery as the basis of the lateral forearm flap. J Reconstr Microsurg. 2000; 16(1): 21–24.
  11. Moore KL, Dalley AF, Agur A. Clinically oriented anatomy. 8th ed. Lippincott Williams and Wilkins 2017.
  12. Przybycień W, Bonczar M, Ostrowski P, et al. The deep brachial artery-A meta-analysis of its origin and diameter with a review of the literature. Clin Anat. 2022; 35(7): 838–846.
  13. Przybycień W, Wysiadecki G, Olszewska A, et al. Diverse variants of the profunda brachii artery: A series of three cases. Transl Res Anat. 2022; 27: 100196.
  14. Przybycień W, Zarzecki M, Musiał A, et al. Anatomy of the deep brachial artery - general overview (cadaveric study) - discussion on terminology. Folia Med Cracov. 2021; 61(3): 85–93.
  15. Rodríguez-Baeza A, Nebot J, Ferreira B, et al. An anatomical study and ontogenetic explanation of 23 cases with variations in the main pattern of the human brachio-antebrachial arteries. J Anat. 1995; 187(Pt 2): 473–479.
  16. Rodríguez-Niedenführ M, Burton GJ, Deu J, et al. Development of the arterial pattern in the upper limb of staged human embryos: normal development and anatomic variations. J Anat. 2001; 199(Pt 4): 407–417.
  17. Tubbs RS, Shoja MM, Loukas M. Bergman’s Comprehensive Encyclopedia of Human Anatomic Variation. Wiley 2016.
  18. Żytkowski A, Tubbs R, Iwanaga J, et al. Anatomical normality and variability: Historical perspective and methodological considerations. Transl Res Anat. 2021; 23: 100105.

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