© Pol J Radiol, 2010; 75(2): 94-97 Waliszewska M et al – Application of the 64-slice computed tomography… Figure 1. Case 1. CTA of the right upper limb – VR reconstruction. Obstruction of the distal part of the brachial artery – with pseudoaneurysm, measuring 17×10 mm, and extensive extravasation of the contrast medium. Figure 2A. Case 2. CTA of both upper limbs – VR reconstruction. Occlusion of the right and left brachial artery – VR reconstruction. Case Report Case 1 Patient J.O., aged 46, was admitted to the emergency surgi- cal department due to an acute ischaemic incident affecting the right upper limb and caused by the crush of the right elbow joint with an agricultural machine. An emergency CTA revealed extensive injuries of the structures within the right cubital fossa, including the brachial artery. On exami- nation, there was a correct contrast medium distribution of the right subclavian artery, axillary artery and brachial artery in its proximal and central part. An occlusion of the Figure 2B. Case 2. Follow-up postoperative CTA – VR reconstruction. Ulnar artery visualised in its whole length, and the radial artery is narrowed from the origin (threadlike lumen), visible till the half of the forearm only. brachial artery was present from the level of the humer- al epicondyle. It was accompanied by a pseudoaneurysm, measuring 17×10 mm, and causing contrast agent extrav- asation with a large haematoma, up to 3 cm thick, occu- pying the anterior part of the distal arm, the cubital fossa and the proximal part of the forearm (Figure 1). Forearm arteries were not opacified. An emergency reconstruction of the brachial artery was performed – a fragment of the saphenous vein was sewed in. The patient was subjected to intraoperative consultation by a hand surgery specialist, who recommended fasciotomy. A clinical improvement in limb perfusion was observed. Case 2 Patient M.M., aged 31, was admitted to the emergency surgi- cal department due to a partial cut-off of both upper limbs with a window pane. This resulted in acute ischaemia. An emergency CTA showed a bilateral occlusion of the brachi- al arteries, from the level of ¼ of the distal humeral shafts. In the left upper limb, below the occlusion site, there were dilated vessels of the collateral circulation, without any evi- dent extravasation of the contrast agent. Forearm arteries remained nonopacified bilaterally (Figure 2A). The patient was subjected to an emergency surgery. The left radial and ulnar artery were anastomosed with a venous graft. On the 95