Vascular injury with fracture of humerus encountered in a case of double axillary artery and double brachial artery - a rare clinical case report

To the best of our knowledge, such a rare combination of double axillary and double brachial arteries encountered in a case of fracture humerus with brachial artery injury is the first to report in clinical practice. A 30-year-old female presented to our accident and emergency department with fracture right humerus and absent right radial pulse. Her contrast-enhanced computed tomographic angiography revealed high bifurcation of right subclavian artery prior to axilla into two axillary arteries. The axillary artery-1 continued as the superficial brachioulnar artery. The axillary artery-2 continued as the deep brachioradial artery with an occlusion in its flow at the level of fracture right humerus. Distal to the occlusion, the deep brachioradial artery continued to form intact palmar arch with superficial brachioulnar artery. The fracture humerus was fixed with plate osteosynthesis and bone grafting. Non-invasive treatment method was chosen for brachial artery injury, intraoperatively. With a complete clinico-radiological investigation and better preoperative planning, we protected her superficial brachioulnar artery from iatrogenic injury. © Int J Anat Var (IJAV). 2013; 6: 170–172.