Quadruple common trunk of the axillary artery and high brachial division: a cadaveric study

This study describes three upper limb arterial variants identified incidentally during systematic cadaveric dissection, with characterisation of their morphometric features, embryological basis, and potential surgical relevance.

Twenty formalin-fixed adult cadavers (40 upper limbs) were systematically dissected bilaterally. Vessel diameters, trunk lengths, and bifurcation levels were measured using digital Vernier callipers (accuracy ± 0.02 mm). Each variant was documented by photography and schematic diagram.

Three variants were identified (3/40 limbs, 7.5%). Case 1: a quadruple common trunk arising from the third part of the axillary artery, 25.3 mm distal to the lateral border of pectoralis minor, giving origin to the lateral thoracic (2.1 mm), subscapular (3.8 mm), circumflex scapular (2.6 mm), and posterior circumflex humeral arteries (1.9 mm). Case 2: high brachial division 15.5 cm proximal to the radial neck, with radial artery traversal of the bicipital aponeurosis. Case 3: high brachial division with a focal ulnar narrowing commencing 22.0 mm from the bifurcation, extending over 8.5 mm, with a minimum diameter of 1.4 mm resolving to 3.2 mm distally.

Three anatomical variants are described with complete morphometric documentation. No identical configuration to Case 1 was identified in the reviewed literature. The findings contribute descriptive cadaveric data. Given the small series and cadaveric setting, all interpretations are offered with due caution.