Double brachial artery dr. kk

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<p>Abstract number : 34167</p> <p>TITLE: Vascular injury with fracture humerus encountered in a case of double axillary artery and double brachial artery - A rare clinical case report.</p> <p> AUTHOURS: Dr. Sanjeev Jain Dr. K. Kalaivanan * Dr. Aditya C Pathak Dr. Amish P Mhatre </p> <p>HOME Dr L H HIRANANDANI HOSPITAL, INDIAINTRODUCTION 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. </p> <p>A 30-year-old female presented to our accident and emergency department with fracture right humerus and absent right radial pulse.HOME Dr L H HIRANANDANI HOSPITAL, INDIACASE STUDYHer contrast-enhanced computed tomographic angiography revealed high bifurcation of right subclavian artery prior to axilla into two axillary arteries. </p> <p>The axillary artery-1 continued as the superficial brachioulnar artery. </p> <p>The axillary artery-2 continued as the deep brachioradial artery with an occlusion in its flow at the level of fracture right humerus.</p> <p> Distal to the occlusion, the deep brachioradial artery continued to form intact palmar arch with superficial brachioulnar artery. HOME Dr L H HIRANANDANI HOSPITAL, INDIACASE STUDYThe fracture humerus was fixed with plate osteosynthesis and bone grafting. Non-invasive treatment method was chosen for brachial artery injury, intraoperatively. </p> <p>With a complete clinico-radiological investigation and better preoperative planning, we protected her superficial brachioulnar artery from iatrogenic injury.</p> <p>HOME Dr L H HIRANANDANI HOSPITAL, INDIACONCLUSION The key message of our study is that every trauma case needs a thorough clinical examination and an adequate radiological examination with proper preoperative planning to avoid iatrogenic injury. </p> <p> This rare branching pattern is named as Jain Variation for literature support.</p> <p>HOME Dr L H HIRANANDANI HOSPITAL, INDIACT ANGIOGRAPH Axillary artery-2 continued as the deep brachioradial artery with an occlusion in its flow at the level of fracture.</p> <p>HOME Dr L H HIRANANDANI HOSPITAL, INDIAFRACTURE PATTERN</p> <p>A - X-RAY AP VIEW # HUMERUS.B - X-RAY LATERAL VIEW # HUMERUS.C - X-RAY AP VIEW HUMERUS PLATING. D - X-RAY LATERAL VIEW HUMERUS PLATING.</p> <p>ABCDHOME Dr L H HIRANANDANI HOSPITAL, INDIAREFRENCES[1]Rodriguez-Niedenfuhr M, Burton GJ, Deu J, Sanudo JR. Development of the arterial pattern in the upper limb of staged human embryos: normal development and anatomic variations. J Anat. 2001; 199: 407417.[2]Rodriguez-Niedenfuhr M, Vazquez T, Nearn L, Ferreira B, Parkin I, Sanudo JR. Variations of the arterial pattern in the upper limb revisited: a morphological and statistical study, with a review of the literature. J Anat. 2001; 199: 547566.[3]Deligonul U, Gabliani G, Kern MJ, Vandormael M. Percutaneous brachial catheterization: the hidden hazard of high brachial artery bifurcation. Cathet Cardiovasc Diagn. 1988; 14: 4445.[4]Prithishkumar IJ, Chathu M. A rare, variant overlapping of the brachioradial and the deep brachial artery in the arm: a potential hazard for angiography. J Clin Diagn Res. 2011; 5: 862864.[5]VijayaBhaskar P, Ritesh R, Shankar PR. Anomalous branching of the axillary artery: A case report. Kathmandu Univ Med J (KUMJ). 2006; 4: 517519. [6]Jayakumari S, Rath G, Arora J. Unilateral double axillary and double brachial arteries. Embryological basis and clinical implications. Int J Morphol. 2006; 24: 463468.[7]Jurjus AR, Correa-De-Aruaujo R, Bohn RC. Bilateral double axillary artery: embryological basis and clinical implications. Clin Anat. 1999; 12: 135140.[8]Hunt CA, Kingsley JR. Vascular injuries of the upper extremity. South Med J. 2000; 93: 466468.[9]Mirdad TM. Neuro-Vascular injuries associated with limb fractures. East Afr Med J. 2000; 77: 663666.[10]Johansen K, Lynch K, Paun M, Copass M. Noninvasive vascular tests reliably exclude occult arterial trauma in injured extremities. J Trauma. 1991; 31: 515519.</p> <p>HOME Dr L H HIRANANDANI HOSPITAL, INDIA</p>