1.Double profunda femoris artery: a unique anatomical variation with surgical significance
Punnapa RAVITEJA ; Mrudula CHANDRUPATLA ; Alka Vithalrao BHINGARDEO
Anatomy & Cell Biology 2026;59(1):193-197
The profunda femoris artery (PFA) originates from the femoral artery, supplying crucial blood flow to thigh muscles, hip joint, and femur. We report a rare unilateral anatomical variation involving an accessory profunda femoris artery (APFA) originating 0.5 cm from the mid-inguinal point (MIP) and a main PFA arising 3.6 cm from the MIP. The APFA supplies the pectineus, adductor longus, and adductor magnus muscles, and gives off the superficial circumflex iliac artery. The main PFA gives rise to circumflex and perforating branches. This variation highlights the complexity of human anatomy and has significant clinical implications, particularly in vascular surgery, plastic surgery, and interventional radiology. Understanding anatomical variations, such as dual PFAs, is crucial for preventing complications during vascular procedures like catheterization and SCIP flap reconstruction. Preoperative assessment and intraoperative adaptability are essential to mitigate risks of arterial injury, dissection, or inadequate perfusion.
2.A rare anatomical variation of the deep femoral vein with aneurysm: a case report with clinical significance
Punnapa RAVITEJA ; Mrudula CHANDRUPATLA ; Rohini MOTWANI ; Saravana Kumar MG
Anatomy & Cell Biology 2026;59(1):198-201
We present a rare anatomical variation of the deep femoral vein (DFV) originating from the popliteal vein (PV) with an associated aneurysm. The DFV arose from the PV at the adductor hiatus, exhibited an aneurysm, and coursed upward through the fourth osseo-aponeurotic opening of the adductor magnus muscle to enter the anterior thigh compartment before draining into the femoral vein. This unique variation likely resulted from developmental deviations during intrauterine life. The anomalous origin and aneurysm of the DFV may potentially cause venous hemodynamic disturbances, chronic venous insufficiency, increased risk of deep vein thrombosis, and potentially life-threatening pulmonary embolism. Anatomical variations of the DFV in terms of origin, course, or termination are rare but clinically relevant, especially in the context of vascular surgeries, imaging, and interventional procedures involving the femoral region.This case highlights the importance of recognizing venous anatomical variations and their clinical implications.
3.Cadaveric revelation of medial cutaneous nerve of the arm traversing the axillary vein
Punnapa RAVITEJA ; Mrudula CHANDRUPATLA ; Rohini MOTWANI
Anatomy & Cell Biology 2025;58(4):638-641
A rare unilateral anatomical variation was observed in the left arm of a 62-year-old female cadaver. The medial cutaneous nerve of the arm pierced the axillary vein, arising from the medial cord of the brachial plexus and coursing posterior to the axillary artery. The nerve traversed the vein over a short segment, entering at approximately 6.5 cm and exiting at approximately 7.5 cm from the coracoid process. This unusual relationship has significant clinical implications in medical procedures, particularly in axillary venous access. Failure to recognize these alterations during axillary lymph node dissections or brachial plexus procedures increases the probability of iatrogenic nerve damage or venous trauma. This case highlights the importance of preoperative imaging and vigilant dissection techniques to accommodate anatomical variability, ultimately enhancing procedural safety and patient outcomes. Recognizing such variations is crucial to prevent sensory deficits, chronic neuropathic pain, and other complications.
4.Study of confluence of hepatic veins application in liver transplantation
Alka Vithalrao BHINGARDEO ; Mrudula CHANDRUPATLA ; Suneeth JOGI ; Annapurna SRIRAMBHATLA ; Kumar Satish RAVI
Anatomy & Cell Biology 2024;57(4):517-522
Liver has exceptional regeneration capacity which makes live donor liver transplantation a good surgical option for patients waiting for donors. Hepatic veins play major role in transplantation surgeries. Variations of hepatic veins can have great impact on surgical approach and outcome of the surgery. In the present study, total number of hepatic veins, presence and absence of accessory veins and confluence with its varied patterns were studied. We found maximum cases with 2 and 3 major hepatic veins which indicate presence of confluence. Confluence between left and middle hepatic veins was highest with 38% of total 54% of cases with confluence. We also found confluence between middle and accessory hepatic vein which is not mentioned in any present classifications. In addition, we have measured confluence length and diameter which holds significance in hepatic resection and anastomosis. The mean confluence length was 0.88±0.39 cm while mean confluence diameter was 0.57±0.20 cm. We found accessory hepatic veins in 15% of cases. The knowledge of this surgical anatomy and associated variations is of paramount importance in liver transplantation, radiological interventional procedures of liver and hepatic tumor resection procedures.
5.Study of confluence of hepatic veins application in liver transplantation
Alka Vithalrao BHINGARDEO ; Mrudula CHANDRUPATLA ; Suneeth JOGI ; Annapurna SRIRAMBHATLA ; Kumar Satish RAVI
Anatomy & Cell Biology 2024;57(4):517-522
Liver has exceptional regeneration capacity which makes live donor liver transplantation a good surgical option for patients waiting for donors. Hepatic veins play major role in transplantation surgeries. Variations of hepatic veins can have great impact on surgical approach and outcome of the surgery. In the present study, total number of hepatic veins, presence and absence of accessory veins and confluence with its varied patterns were studied. We found maximum cases with 2 and 3 major hepatic veins which indicate presence of confluence. Confluence between left and middle hepatic veins was highest with 38% of total 54% of cases with confluence. We also found confluence between middle and accessory hepatic vein which is not mentioned in any present classifications. In addition, we have measured confluence length and diameter which holds significance in hepatic resection and anastomosis. The mean confluence length was 0.88±0.39 cm while mean confluence diameter was 0.57±0.20 cm. We found accessory hepatic veins in 15% of cases. The knowledge of this surgical anatomy and associated variations is of paramount importance in liver transplantation, radiological interventional procedures of liver and hepatic tumor resection procedures.
6.Study of confluence of hepatic veins application in liver transplantation
Alka Vithalrao BHINGARDEO ; Mrudula CHANDRUPATLA ; Suneeth JOGI ; Annapurna SRIRAMBHATLA ; Kumar Satish RAVI
Anatomy & Cell Biology 2024;57(4):517-522
Liver has exceptional regeneration capacity which makes live donor liver transplantation a good surgical option for patients waiting for donors. Hepatic veins play major role in transplantation surgeries. Variations of hepatic veins can have great impact on surgical approach and outcome of the surgery. In the present study, total number of hepatic veins, presence and absence of accessory veins and confluence with its varied patterns were studied. We found maximum cases with 2 and 3 major hepatic veins which indicate presence of confluence. Confluence between left and middle hepatic veins was highest with 38% of total 54% of cases with confluence. We also found confluence between middle and accessory hepatic vein which is not mentioned in any present classifications. In addition, we have measured confluence length and diameter which holds significance in hepatic resection and anastomosis. The mean confluence length was 0.88±0.39 cm while mean confluence diameter was 0.57±0.20 cm. We found accessory hepatic veins in 15% of cases. The knowledge of this surgical anatomy and associated variations is of paramount importance in liver transplantation, radiological interventional procedures of liver and hepatic tumor resection procedures.
7.Tri-ramification of left external carotid artery associated with anatomical variation of its branches and aneurysm formation
Punnapa RAVITEJA ; Mrudula CHANDRUPATLA ; Rohini MOTWANI
Anatomy & Cell Biology 2024;57(2):324-327
Essential sources of arterial vascularisation in the head and neck region are the left and right common carotid arteries (CCA) and their branches. The left CCA (LCCA) originates from the arch of the aorta and the right CCA originates from the brachiocephalic trunk. In this case report, there was a bilateral higher division of CCA at the plane of the greater cornua of the hyoid bone, unilateral tri-ramification of the LCCA and the left external carotid artery (LECA), and the origin of the linguo-facial trunk and the pharyngo-occipital trunk from the LECA. An aneurysm formed in the distal part of LECA before its termination. In this case, we propose a novel categorization called the punnapatla classification for the anatomical variance branching forms of ECA. These kinds of variations are important to the surgeons, and anaesthetists, during the surgeries of the head and neck.
8.An anomalous pseudoganglion associated with high division of sciatic nerve
Alka Vithalrao BHINGARDEO ; Ayush AMLAN ; Mrudula CHANDRUPATLA ; Shailaja PRABHALA ; Shrinivas SOMALWAR
Anatomy & Cell Biology 2024;57(2):320-323
Sciatic nerve (SN) is the thickest and longest nerve of the body. Deviations from the normal anatomical origin and level of bifurcation of SN have been frequently reported. In the present case, we are presenting a unique scenario of origin of terminal branches of the SN-tibial nerve (TN) and common peroneal nerve (CPN) in the pelvic region itself from divisions arising directly from the lumbosacral plexus. This variation was associated with origin of posterior femoral cutaneous nerve from the superior division of CPN with anomalous communicating branches between pudendal nerve and TN. The unique characteristics of the present case are the presence of ‘pseudoganglion’ found on the inferior division of TN. The present case stands out as the first of its kind to mention such pseudoganglion. Knowledge of some unusual findings like presence of pseudoganglion and intercommunications between nerves have clinical implications in anesthesiology, neurology, sports medicine, and surgery.
9.Study of confluence of hepatic veins application in liver transplantation
Alka Vithalrao BHINGARDEO ; Mrudula CHANDRUPATLA ; Suneeth JOGI ; Annapurna SRIRAMBHATLA ; Kumar Satish RAVI
Anatomy & Cell Biology 2024;57(4):517-522
Liver has exceptional regeneration capacity which makes live donor liver transplantation a good surgical option for patients waiting for donors. Hepatic veins play major role in transplantation surgeries. Variations of hepatic veins can have great impact on surgical approach and outcome of the surgery. In the present study, total number of hepatic veins, presence and absence of accessory veins and confluence with its varied patterns were studied. We found maximum cases with 2 and 3 major hepatic veins which indicate presence of confluence. Confluence between left and middle hepatic veins was highest with 38% of total 54% of cases with confluence. We also found confluence between middle and accessory hepatic vein which is not mentioned in any present classifications. In addition, we have measured confluence length and diameter which holds significance in hepatic resection and anastomosis. The mean confluence length was 0.88±0.39 cm while mean confluence diameter was 0.57±0.20 cm. We found accessory hepatic veins in 15% of cases. The knowledge of this surgical anatomy and associated variations is of paramount importance in liver transplantation, radiological interventional procedures of liver and hepatic tumor resection procedures.
10.Study of confluence of hepatic veins application in liver transplantation
Alka Vithalrao BHINGARDEO ; Mrudula CHANDRUPATLA ; Suneeth JOGI ; Annapurna SRIRAMBHATLA ; Kumar Satish RAVI
Anatomy & Cell Biology 2024;57(4):517-522
Liver has exceptional regeneration capacity which makes live donor liver transplantation a good surgical option for patients waiting for donors. Hepatic veins play major role in transplantation surgeries. Variations of hepatic veins can have great impact on surgical approach and outcome of the surgery. In the present study, total number of hepatic veins, presence and absence of accessory veins and confluence with its varied patterns were studied. We found maximum cases with 2 and 3 major hepatic veins which indicate presence of confluence. Confluence between left and middle hepatic veins was highest with 38% of total 54% of cases with confluence. We also found confluence between middle and accessory hepatic vein which is not mentioned in any present classifications. In addition, we have measured confluence length and diameter which holds significance in hepatic resection and anastomosis. The mean confluence length was 0.88±0.39 cm while mean confluence diameter was 0.57±0.20 cm. We found accessory hepatic veins in 15% of cases. The knowledge of this surgical anatomy and associated variations is of paramount importance in liver transplantation, radiological interventional procedures of liver and hepatic tumor resection procedures.

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