scholarly journals Bilateral Tortuous Upper Limb Arterial Tree and Their Clinical Significance

2020 ◽  
pp. 1-3
Author(s):  
Alka Bhingardeo ◽  

The detailed knowledge about the possible anatomical variations of upper limb arteries is vital for the reparative surgery of the region. Brachial artery is the main artery of upper limb; it is a continuation of axillary artery from the lower border of teres major muscle. During routine cadaveric dissection, we found bilateral tortuous brachial artery which was superficial as well as tortuous throughout its course. It is called superficial as it was superficial to the median nerve. At the neck of radius, it was divided into two terminal branches radial and ulnar arteries which were also tortuous. Tortuosity of the radial artery was more near the flexor retinaculum. When observed, the continuation of ulnar artery as superficial palmar arch also showed tortuosity throughout, including its branches. Being superficial such brachial artery can be more prone to trauma. Tortuous radial artery is one of the causes of access failure in trans-radial approach of coronary interventions. To the best of our knowledge, this is the first case where entire post axillary upper limb arterial system is tortuous bilaterally. So knowledge of such tortuous upper limb arterial tree is important for cardiologist, radiologist, plastic surgeons and orthopedic surgeons

1970 ◽  
Vol 7 (3) ◽  
pp. 293-297 ◽  
Author(s):  
P Baral ◽  
P Vijayabhaskar ◽  
S Roy ◽  
S Kumar ◽  
S Ghimire ◽  
...  

An isolated neurovascular variation is common but multiple vascular anomalies on same upper limb is a very rare case. We observed an unusual variations in right upper limb during routine dissection of a Nepali cadaver. The variations were observed in Axilla, Forearm and Palm. In axilla, first part of axillary artery did not give any branch, the second part of axillary artery gave off only two branches - (a) thoracoacromial artery and (b) a large common trunk which later gave off lateral thoracic, thoracodorsal, subscapular, posterior circumflex scapular and then continued as posterior circumfl ex humeral artery. The third part of axillary artery gave off only anterior circumflex humeral artery. In forearm, the ulnar artery runs downward superficial to flexor muscles. Here, radial artery gave off common interosseous artery. In palm radial artery did not give any contribution to superficial palmar arch which is solely formed by the continuation of ulnar artery. This type of anomalies are very rare and is not reported in Nepalese cadaver at all. These anomalies are described in detail and their clinical relevance is highlighted. Key words: Axillary artery; Brachial artery; Radial artery; Ulnar artery; Palmar arch; Variations DOI: 10.3126/kumj.v7i3.2740 Kathmandu University Medical Journal (2009) Vol.7, No.3 Issue 27, 293-297


2015 ◽  
Vol 88 (4) ◽  
pp. 545-549
Author(s):  
Ivan Maslarski

Variations of arterial patterns in the upper limb have represented the most common subject of vascular anatomy. Different types of artery branching pattern of the upper limb are very important for orthopedists in angiographic and microvascular surgical practice.The brachial artery (BA) is the most important vessel in the normal vascular anatomy of the upper limb. The classical pattern of the palmar hand region distribution shows the superficial palmar arch. Normally this arch is formed by the superficial branch of the ulnar artery and completed on the lateral side by one of these arteries: the superficial palmar branch of the radial artery, the princeps pollicis artery, the superficial palmar branch of the radial artery or the median artery.After the routine dissection of the right upper limb of an adult male cadaver, we found a very rare variant of the superficial arch artery – a division in a higher level brachial artery. We found this division at 10.4 cm from the beginning of the brachial artery. This superficial brachial artery became a radial artery and was not involved in the formation of the palm arch. In the forearm region, the artery variant was present with the median artery and the ulnar artery, which form the superficial palm arch.


2021 ◽  
Vol 20 ◽  
Author(s):  
Laishram Sophia ◽  
Darshita Singh ◽  
Neha Xalxo ◽  
Anjoo Yadav ◽  
Sneh Agarwal ◽  
...  

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.


2014 ◽  
Vol 03 (04) ◽  
pp. 225-228
Author(s):  
Sankaran PK ◽  
Gunapriya Raghunath ◽  
Sathyan R. ◽  

AbstractDuring routine dissection of upper limb, a variation in the origin of radial artery was observed in a female cadaver of about 60 years. The radial artery is usually a smaller terminal branch of the brachial artery in the forearm. On the right side of the cadaver the radial artery was found to originate from second part of the axillary artery, whereas on the left side the origin of radial artery was found to be normal. This variant of radial artery has been rarely documented in literature. Accurate anatomy of radial artery and its variations have definite diagnostic, interventional, and surgical significance.


Author(s):  
R. S. Jnanesh

Background: Variations in upper limb arteries have been frequently observed. Accurate knowledge of muscular and neurovascular variations is important for both surgeons and radiologists, which may prevent diagnostic errors.Methods: A study was done to note the variations in the termination of brachial artery in relation to the level of termination and the terminal branches. A total of 60 upper limbs (33 Right, 27 Left) were studied. The level of termination of brachial artery was identified based on the distance between the intercondylar line and the point of termination. The classic textbook description of brachial artery bifurcating into radial and ulnar arteries, 1 cm distal to elbow joint (ICL) was taken as normal.Results: A high origin of radial artery was noted in 11.67% of cases. Variations in the origin and relationship of median nerve to brachial artery, radial artery and ulnar artery was seen in 4 cases.Conclusions: Due to higher incidence of anatomical variations of arteries of the upper limb, prior anatomical knowledge of anomalies is of great clinical significance to vascular surgeons, orthopaedicians and radiologists performing angiographic studies.


2020 ◽  
pp. 123-123
Author(s):  
Ankita Chauhan ◽  
Suman Yadav

The radial artery is commonly accessed for many vascular and reconstructive surgeries and also for arterial blood sampling and cannulation procedures. The radial artery commences from the brachial artery at the level of neck of the radius in the cubital fossa. Proximally, it is overlapped anteriorly by brachioradialis muscle, but elsewhere in its course it is covered only by the skin, superficial and deep fasciae. During routine dissection of left upper limb of adult male cadaver in accordance with ethical standards at the department of anatomy at Dr. RPGMC Kangra at Tanda, high origin of the radial artery from brachial artery was observed. The brachial artery after giving profunda brachii branch divides in the proximal 1/3rd of arm, corresponding to the origin of brachialis muscle into radial artery and a common trunk for ulnar and common interroseous arteries. The course of radial artery was superficial throughout the arm and forearm. The radial artery on the right side had normal origin and course. This high origin radial artery is termed as brachioradial artery in the literature. Variations in the arterial tree of upper limb are fairly common, having an embryological basis. Accurate anatomical knowledge of the variation is of great clinical importance in performing many diagnostic and therapeutic procedures so as to avoid any iatrogenic injury.


2011 ◽  
Vol 5 (1) ◽  
pp. 151-155 ◽  
Author(s):  
David Kachlik ◽  
Marek Konarik ◽  
Miroslav Urban ◽  
Vaclav Baca

Abstract Background: The accessory brachial artery (arteria brachialis accessoria) is a rare upper limb vascular abnormality, reported in less than one percent of cases. It is the artery originating from the axillary artery or the brachial artery, which rejoins the brachial artery further along its distal course within the arm or cubital fossa. Its detailed knowledge is necessary in transradial transulnar catheterization during coronary procedures, mainly due to its narrow caliber, which is responsible for the failure of the intervention performance. Objectives: Present a case of uncharacteristic branching pattern of the accessory brachial artery. Method: The case was observed during a routine dissection in the left axilla of a female cadaver at the Department of Anatomy at the Third Faculty of Medicine, Charles University in Prague. Results: The infrapectoral part of the axillary artery gave rise to a branch that descended distally along the medial side of the arm. This artery accompanied firstly the ulnar nerve, then it diverted laterally towards the median nerve and coursed hidden behind it to re-enter the brachial artery within the distal part of the arm, next to the biceps brachii muscle. The calibre of the accessory brachial artery was two mm only. Conclusion: The accessory brachial artery is a rare variant of the upper limb vascular system and its prevailingly narrow lumen can cause a failure of the transradial/transulnar catheterization intervention.


2007 ◽  
Vol 6 (3) ◽  
pp. 284-287
Author(s):  
Srinivasulu Reddy ◽  
Venkata Ramana Vollala

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.


2020 ◽  
Vol 2020 (9) ◽  
Author(s):  
Mahmoud Tolba ◽  
Martin Maresch ◽  
Dhafer Kamal

Abstract We present a case of dialysis associated steal syndrome in a hemodialysis patient with left radiocephalic arteriovenous fistula that caused him severe rest pain. Angiography showed retrograde flow from the ulnar artery to the distal radial artery through a hypertrophied palmar arch. The problem was solved by surgical ligation of the distal radial artery leading to complete relief of patient symptoms without any notable complications.


2015 ◽  
Vol 04 (02) ◽  
pp. 107-109
Author(s):  
Ashwini Mutalik ◽  
Chandrashekhar Hanji ◽  
Sanjeev I Kolagi ◽  
GB Rairam

AbstractDuring routine dissection of a cadaver alloted to the undergraduate students in the department of anatomy in SN Medical College, Bagalkot, the authors found multiple variations in the branching pattern of brachial, ulnar and radial arteries. There was high division of brachial artery into ulnar and radial arteries. The profunda brachii originated from brachial artery as usual while superior and inferior ulnar collateral arteries originated from ulnar artery. The radial artery gave origin to common interosseous artery which further divided into anterior and posterior interosseous arteries. All the three arteries i.e. brachial, ulnar and radial were considered as superficial arteries as they were superficial throughout the course. These observations of vascular anomalies are of clinical significance to vascular and plastic surgeons.


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