Anatomical variations of the terminal branching of the brachial artery

Objective Knowledge regarding arterial variations is important during surgeries, intra-arterial injections, venipuncture and imaging of the upper limb. Our objective was to document brachial artery variations. Methods We studied 54 upper limb specimens during routine dissection. The anterior compartment of the arm, cubital fossa and the forearm were dissected and the pathway and the distribution of the brachial artery and its branches were documented. Results Variations of the brachial artery anatomy were noted in 3 specimens (5%). Unilateral high bifurcation of brachial artery was noted in two specimens on the left side. In one of these, bifurcation was directly from the axillary artery at the axilla just proximal to the formation of the median nerve. Here the brachial artery divided into its terminal radial and ulnar branches. In the other specimen, the brachial artery bifurcated into radial and ulnar arteries at the level of the mid humerus. In the other specimen, the brachial artery was seen to trifurcate into radial, ulnar and common interosseus arteries at the level of the neck of the radius. Conclusions High brachial artery bifurcation and trifurcation of the brachial artery in the upper arm was noted in this study. Reporting of such variations in different populations is important for the practicing clinician during diagnostic and surgical procedures.