Presentation
Numbness of left finger tips.
Patient Data
CT angiogram of upper limbs show thin (<2 mm) hypoplastic brachioradial artery arising from anterior surface of brachial artery in mid arm. It courses inferiorly upto cubital fossa and is reinforced by a dominant (3 mm; larger in diameter than the brachial segment of radial artery) cubital cross-over (radial recurrent branch).
The artery then continues as radial artery in forearm with same caliber as that of cubital cross-over artery.
The dense contrast in right upper limb veins is partly obscuring the details.
MIP image of arterial tree of both upper limbs show thin hypoplastic right brachioradialis artery (partially seen in interruption) with dominant (larger caliber than the brachial segment of artery), tortuous cubital cross-over. It then continues in the forearm as radial artery of similar caliber.
Thin brachioradial artery in VR image is artificially drawn line, superimposed on the arterial tree for better depiction.
Case Discussion
Brachioradial artery variations should be kept in mind to prevent misdiagnosis. There are different variations of brachioradial artery origins and the cubital cross-over (dominant, balanced or minimal).