Vascular patterns of upper limb: an anatomical study with accent on superficial brachial artery

Anomalies of the ramification of arteries in the upper extremity are an important consideration due to the large number of invasive procedures, both diagnostic and therapeutic, performed particularly in the cubital region of the upper limb. It is important for health professionals to be aware of arterial variation to prevent complications during diagnostic and therapeutic procedures. Here, we describe a rare unilateral anomaly of the brachial artery which courses subcutaneously through the right arm to the cubital region in a 75 year-old female patient.

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A cadaveric study of brachial artery and its variations with its ontogenic basis: An Anatomical Perspective

International Journal of Anatomy and Research ◽

10.16965/ijar.2020.233 ◽

2021 ◽

Vol 9 (9) ◽

pp. 7844-7850

Author(s):

Monika Lalit ◽

◽

Sanjay Piplani ◽

Keyword(s):

Upper Limb ◽

Brachial Artery ◽

Ulnar Artery ◽

Branching Pattern ◽

Age Group ◽

Upper Limbs ◽

Morphological Pattern ◽

Superficial Brachial Artery ◽

Interosseous Artery ◽

Cubital Fossa

Introduction: Conventional knowledge of the brachial artery, the principal artery of the upper limb & its branches has played a major role in vascular surgeries. Literature along with various cadaveric & clinical studies suggest that brachial artery vary widely in origin, course and branching pattern. The great variability of this arterial pattern may be attributed to the failure of regression of some paths of embryonic arterial trunks. Anatomical knowledge of this principal artery and its variations has many clinical implications especially in surgeries related to orthopedic and vascular re-constructive procedures. MATERIALS AND METHODS: The present study was conducted on 56 upper limbs of different age group and sex (19 Male and 9 Female) The brachial arteries were identified and branching pattern and relations of the brachial artery with brachial plexus in arm was observed and presence or absence of variations were documented. Results: Out of 56 upper limbs studies, 53 (94.64%) limbs showed normal morphological pattern of brachial artery, 3 (5.35%) limbs showed superficial brachial artery, 1 limb (1.78%) showed tortuous and SBA with trifurcation into radial artery, ulnar artery and common interosseous artery in the cubital fossa. Conclusion: The study of Brachial artery and variation in its course and branching pattern is clinically important for surgeons, ortho-paedicians operating on the supracondylar fracture of humerus and radiologists performing angiographic studies on the upper limb. KEY WORDS: Common Interosseous Artery, Median Nerve, Superficial Brachial Artery, Trifurcation, Ulnar Artery.

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Upper limb arterial pattern: clinical correlation and embryological perspective

Jornal Vascular Brasileiro ◽

10.1590/1677-5449.210008 ◽

2021 ◽

Vol 20 ◽

Author(s):

Laishram Sophia ◽

Darshita Singh ◽

Neha Xalxo ◽

Anjoo Yadav ◽

Sneh Agarwal ◽

...

Keyword(s):

Upper Limb ◽

Brachial Artery ◽

Axillary Artery ◽

Common Trunk ◽

New Delhi ◽

Palmar Arch ◽

Medical College ◽

Human Cadavers ◽

Median Artery ◽

Development Methods

Abstract Background Variations in the upper limb arterial pattern are commonplace and necessitate complete familiarity for successful surgical and interventional procedures. Variance in the vascular tree may involve any part of the axis artery of the upper limb, including the axillary artery and brachial artery or its branches, in the form of radial and ulnar arteries, which eventually supply the hand via anastomosing arches. Objectives To study the peculiarities of the arterial pattern of the upper limb and to correlate them with embryological development. Methods The entire arterial branching of forty-two upper limbs of formalin fixed adult human cadavers was examined during routine dissection for educational purposes, conducted over a 3-year period in the Department of Anatomy, Lady Hardinge Medical College, New Delhi. Results The study found: 1) One case in which a common trunk arose from the third part of the axillary artery, which immediately splayed into four branches (2.4%); 2) High division of the brachial artery into ulnar and radial arteries, in 3 cases (7.1%); 3) Pentafurcation of the brachial artery into ulnar, interosseus, radial, and radial recurrent arteries and a muscular twig to the brachioradialis in 1/42 cases (2.4%); 4) Incomplete Superficial Palmar arch in 3/42 cases (7.1%); and 5) Presence of a median artery in 2/42 case(4.8%) Conclusions This study observed and described the varied arterial patterns of the upper limb and identified the various anomalous patterns, supplementing the surgeon’s armamentarium in various surgical procedures, thereby helping to prevent complications or failures of reconstructive surgeries, bypass angiography, and many similar procedures.

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Unilateral high division of brachial artery

National Journal of Clinical Anatomy ◽

10.1055/s-0039-3401598 ◽

2016 ◽

Vol 05 (02) ◽

pp. 266-272

Author(s):

T. M. Sucharitha ◽

L. Hema ◽

S. V. Phanindra

Keyword(s):

Upper Limb ◽

Brachial Artery ◽

Clinical Importance ◽

Branching Pattern ◽

Invasive Procedures ◽

Arterial Variations ◽

Female Cadaver ◽

Variation Patterns ◽

Cubital Fossa ◽

The Right

AbstractArterial variations in the arm are of great clinical importance as this area is commonly involved in many surgical and invasive procedures. During dissection, we observed in the right upper limb a variation in the division and branching pattern of brachial artery in a female cadaver. The short segmented brachial artery divided about 6 cms. above the line joining the epicondyles of the humerus, but not in the cubital fossa. The course of the two divisions in the forearm is normal. Knowledge of these variation patterns is useful during surgeries.

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A Variation In The Origin And Course Of The Posterior Circumflex Humeral Artery And The Deep Brachial Artery: Clinical Importance Of The Variation

Journal of Biomedical and Clinical Research ◽

10.1515/jbcr-2015-0169 ◽

2015 ◽

Vol 8 (2) ◽

pp. 164-167

Author(s):

Alexandar A. Iliev ◽

Lazar G. Mitrov ◽

Georgi P. Georgiev

Keyword(s):

Blood Supply ◽

Upper Limb ◽

Brachial Artery ◽

Clinical Relevance ◽

Clinical Importance ◽

Deltoid Muscle ◽

Axillary Nerve ◽

Anatomical Dissection ◽

Teres Major ◽

Posterior Circumflex Humeral Artery

Summary A case of an unusual variation of the blood supply of an upper limb is presented. During a routine anatomical dissection, it was found that the posterior circumflex humeral artery had an unusual course and branching. It arose as a branch of the brachial artery, not the axillary one, and it did not accompany the axillary nerve. It ran under the lower border of the teres major muscle instead of passing through the lateral axillary foramen, then followed its usual course around the surgical neck of the humerus, supplying the deltoid muscle. It was also found that instead of arising from the brachial artery, the deep brachial artery arose from the posterior circumflex humeral artery. Variations are reported and their clinical relevance is discussed.

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Acute Upper Limb Ischemia Due to Delayed Presentation of a Brachial Artery Pseudoaneurysm Post-Venipuncture

Vascular and Endovascular Surgery ◽

10.1177/1538574419877620 ◽

2019 ◽

Vol 54 (1) ◽

pp. 80-84 ◽

Cited By ~ 2

Author(s):

Adele H. H. Lee ◽

Sara D. Qi ◽

Nathaniel Chiang

Keyword(s):

Median Nerve ◽

Upper Limb ◽

Brachial Artery ◽

Limb Ischemia ◽

High Morbidity ◽

Delayed Presentation ◽

Artery Pseudoaneurysm ◽

Hand Ischemia ◽

Iatrogenic Trauma ◽

Median Nerve Neuropathy

Brachial artery pseudoaneurysms (BAPs) are rare but could lead to complications of high morbidity. We report a case of a BAP presenting with hand ischemia and median nerve neuropathy nearly a decade after the inciting iatrogenic trauma, successfully treated with excision and direct repair. This report highlights that untreated pseudoaneurysms can be indolent and present late with both symptoms of embolization and local compression.

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Abstract No. 316: Acute Upper Limb Ischemia: Usefulness of Aspiration Thrombectomy After Brachial Artery Puncture

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2008.12.311 ◽

2009 ◽

Vol 20 (2) ◽

pp. S118-S119

Author(s):

H. Kwak ◽

Y. Han

Keyword(s):

Upper Limb ◽

Brachial Artery ◽

Limb Ischemia ◽

Aspiration Thrombectomy

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The superficial ulnar artery: development and clinical significance

Jornal Vascular Brasileiro ◽

10.1590/s1677-54492007000300013 ◽

2007 ◽

Vol 6 (3) ◽

pp. 284-287

Author(s):

Srinivasulu Reddy ◽

Venkata Ramana Vollala

Keyword(s):

Clinical Significance ◽

Upper Limb ◽

Brachial Artery ◽

Biceps Brachii ◽

Ulnar Artery ◽

Wide Range ◽

Male Cadaver ◽

Median Cubital Vein ◽

Muscular Branch ◽

Superficial Ulnar Artery

The principal arteries of the upper limb show a wide range of variation that is of considerable interest to orthopedic surgeons, plastic surgeons, radiologists and anatomists. We present here a case of superficial ulnar artery found during the routine dissection of right upper limb of a 50-year-old male cadaver. The superficial ulnar artery originated from the brachial artery, crossed the median nerve anteriorly and ran lateral to this nerve and the brachial artery. The superficial ulnar artery in the arm gave rise to a narrow muscular branch to the biceps brachii. At the elbow level the artery ran superficial to the bicipital aponeurosis where it was crossed by the median cubital vein. It then ran downward and medially superficial to the forearm flexor muscles, and then downward to enter the hand. At the palm, it formed the superficial and deep palmar arches together with the branches of the radial artery. The presence of a superficial ulnar artery is clinically important when raising forearm flaps in reconstructive surgery. The embryology and clinical significance of the variation are discussed.

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