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Variant course of posterior circumflex humeral artery associated with the abnormal origin of radial collateral artery: could it mimic the quadrangular space syndrome?

Mohandas Rao KG, Somayaji SN, Ashwini LS, Ravindra S, Abhinitha P, Rao A, et al.

Acta Med Iran, 2012;50(8):572-6.
PMID: 23109033

Variations in the origin of axillary artery branches are common. But, distinctly abnormal course of its posterior circumflex humeral branch is rare. We are reporting a case of posterior circumflex humeral artery (PCHA) originating from the axillary artery, passing through lower triangular space to reach the scapular region where it accompanied the axillary nerve and posterior circumflex humeral vein to pass around surgical neck of humerus, deep to the fibers of deltoid. Other variations observed in this specimen were the radial collateral artery arising from the PCHA, middle collateral artery arising directly from the brachial artery and absence of profunda brachii artery. PCHA forming a hair pin loop, traversing through lower triangular space instead of quadrangular space taking a long course is being reported for the first time. Further, the clinical and surgical importance of this case especially in relation with quadrangular space syndrome and relevant literature is discussed.
Variant origin of an arterial trunk from axillary artery continuing as profunda brachii artery--a unique arterial variation in the axilla and its clinical implications

Naveen K, Jyothsna P, Nayak SB, Mohandas RK, Swamy RS, Deepthinath R, et al.

Ethiop J Health Sci, 2014 Jan;24(1):93-6.
PMID: 24591805

BACKGROUND: Axillary artery is known to show different variations mostly in its branching pattern. Similarly, the origin of profunda brachii is often encountered with abnormality. Therefore, when the vascular variations in the upper limb persist, mostly it is confined to its branching pattern followed by its variant origin. But, among all the reported variations of profunda brachii, its variant origin from the 3rd part of the axillary artery with common trunk for the branches of axillary artery is unique.
CASE DETAILS: We report here an anomalous origin of profunda brachii as continuation of an arterial trunk arising from 3rd part of the axillary artery. This common trunk at its commencement passed between 2 roots of median nerve and gave branches of 3rd part of axillary artery before it continued as profunda brachii artery. The further course and branching pattern of profunda brachii were normal.
CONCLUSION: Since the axillary artery is next choice of artery for arterial cannulation in cardiopulmonary bypass procedures, prior knowledge of existence of such variation in its branching pattern helps in avoiding possible diagnostic or interventional therapeutic errors.

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