Communicating artery between posterior circumflex humeral artery and deep brachial artery: case report, literature review and clinical implications

Purpose: Knowledge of a large communication between posterior circumflex humeral and deep brachial arteries, although infrequent, it is important to avoid damage during a Leechavengvongs procedure or used as recipient artery in free flaps for upper limb reconstruction.

Methods: A dissection of a latex-injected cadaver revealed the presence of a large communication between the posterior circumflex humeral and deep brachial arteries. Furthermore, this communicating artery was observed during a Leechavengvongs procedure. A comprehensive review of the existing literature on the anatomical variations of the posterior circumflex humeral and deep brachial arteries was conducted.

Results: A communicating artery between the posterior circumflex humeral and deep brachial arteries was identified during a routine dissection. This communicating artery establishes a posterior collateral pathway of substantial caliber between the axillary and the brachial arteries. Given its oblique trajectory posteriorly along the humeral shaft, this artery is susceptible to injury during a posterior approach to the humerus. Despite the existence of numerous anatomical variations involving the posterior circumflex humeral and deep brachial arteries, this communicating artery has not been previously described in the literature. Additionally, we report this anatomical variation crossing the surgical field during a Leechavengvongs procedure.

Conclusion: Our findings suggest that a large communicating artery between the posterior circumflex humeral artery and the deep brachial artery has the potential to cross the surgical field and become a source of risk during a posterior approach to the arm. It can also be used as recipient artery in free flaps for upper limb reconstruction.