Anatomical variations of radial artery and its morphology with clinical implications
DOI:
https://doi.org/10.18203/2320-6012.ijrms20222635Keywords:
RA, Brachial artery, Ulnar artery, Recurrent RA, Anterior interosseous artery, Arteria princeps pollicis, Superficial palmar archAbstract
Background: The radial artery (RA) is a continuation of the brachial artery and is one of the major blood supplying vessels to the structures of the forearm. It is originated in the cubital fossa at the level of the neck of the radius. It runs on the lateral aspect of the forearm before it reaches the wrist and branches out to supply the hand. The RA is also important clinically due to its location at the wrist, as it can be felt as a pulse and can be used to determine the heart rate. It is the artery of choice for coronary artery angiography, percutaneous coronary artery intervention, cannulation, and others. The main objective of this study is to study the variation in origin and course of the RA in cadavers.
Methods: The present study was conducted with 100 upper limbs of 50 cadavers in the department of anatomy, Gouri devi institute medical sciences and hospital, Durgapur, West Bengal over a period of 2 years. By conventional dissection method, the axillary region, arm, forearm, and hand of each limb were dissected to clarify the course and branches of the RA. This anatomical descriptive study was conducted after approval of the ethical committee. The study period was March 2018 to August 2020.
Results: RA took high origin from the brachial artery in arm is 6.66%. The maximum length was measured was 23.7 cm, minimum length was 18 cm and the mean value is 21.25. The RA after giving its branches continued in the forearm. In 96.88%, RA arose normally in cubital fossa.
Conclusions: The anatomy and morphology of RA have many documented variations. Radiologist and surgeons should have a good understanding of normal morphological variations of RA.
References
Aragão JA, Da Silva AFC, Anunciação CB, Reis FP. Median artery of the forearm in human fetuses in northeastern Brazil: anatomical study and review of the literature. Anatom Sci Int. 2017:92(1):107-11.
Cikla DM, Tumturk A, Baskaya MK. Overcoming end-to-end vessel mismatch during superficial temporal artery–radial artery–M2 interposition grafting for cerebral ischemia: tapering technique. World Neurosurg. 2018;110-85.
Jennings AM, Mushtaq N. Proximal radial artery arteriovenous fistula for hemodialysis vascular access. J Vascular Surg. 2017;67(1):244-53.
Kachlik PH, Konarik M, Krchov M, Baca V. Coincidence of superficial brachiomedian artery and bitendinouspalmarislongus: a case report. Surg Radiolog Anatomy. 2016;38(1):147-51.
Shetty SD, Nayak BS, Madhav NV, Sirasanagandla SR, Abhinitha P. The Abnormal Origin, course and the distribution of the arteries of the upper limb: a case report. J Clin Diagnost Res. 2012;6(8):1414-6.
Singer G, Marterer R, Till H, Schmidt B. A rare anatomic variation of the superficial palmar branch of the radial artery causing pain. Surgical Radiologic Anatomy. 2018;40(3):349-52.
Adachi B. Das Arteriensystem der Japaner. Maruzen, Kyoto edition. 1928;1:285-356.
Karlsson S, Niechajev IA. Arterial anatomy of the upper extremity. Acta Radiologica. 1982;23(2):115-21.
Lee H, Moon Y, Park HS, Kim H, Choi I. A radial artery originating from the thoracoacromial artery. Surgical Radiologic Anatomy. 2016;38(5):631-3.
McCormack LJ, Cauldwell EW, Anson BJ. Brachial and antebrachial arterial patterns; a study of 750 extremities. Surg Gynecol Obstetr. 1953;96:43-54.
Nasr AY. The radial artery and its variations: anatomical study and clinical implications. Folia Morphologica. 2012;71(4):252-62.
Rodríguez-Niedenführ M, Vázquez T, Nearn L, Ferreira B, Parkin I, Sañudo JR. Variations of the arterial pattern in the upper limb revisited: a morphological and statistical study, with a review of the literature. J Anatomy. 199;5:547-66.
Rodríguez-Niedenführ T, Vázquez IG, Parkin, Sañudo JR. Arterial patterns of the human upper limb: Update of anatomical variations and embryological development. Euro J Anatomy. 2003;7(1):21-8.
Weathersby HT. Anomalies of brachial and antebrachial arteries of surgical significance. Southern Med J. 1956;49(1):46-9.
Wysiadecki G, Polguj M, Haładaj R, Topol M. Low origin of the radial artery: a case study including a review of literature and proposal of an embryological explanation. Anatomical Sci Int. 2017;92(2):293-8.
Hamahata A, Nakazawa H, Takeuchi M, Sakurai H. Usefulness of radial recurrent artery in transplant of radial forearm flap: An anatomical and clinical study. J Reconstructive Microsurg. 2012;28(3):195-8.
Rodríguez-Niedenführ M, Sañudo JR, Vázquez T, Nearn L, Logan B, Parkin I. Anastomosis at the level of the elbow joint connecting the deep, or normal, brachial artery with major arterial variations of the upper limb. J Anatomy. 2000;196:115-9.
Vazquez J, Sañudo R, Carretero J, Parkin I, Rodríguez-Niedenführ M. Variations of the radial recurrent artery of clinical interest. Surgical Radiol Anatomy. 2013;35(8):689-94.
Kaplanoglu OB. Evaluation of anatomy and variations of superficial palmar arch and upper extremity arteries with CT angiography. Surgical Radiol Anatomy. 2017;39(4):419-26.
Standring S. Grays Anatomy: The Anatomical Basis of Clinical Practice, in Gray’s Anatomy: The Anatomical Basis of Clinical Practice, Churchill Livingstone, Edinburgh, London, 40th edition. 2008;905-6.
Anagnosto PS, Venieratos D. An unusual branching pattern of the superficial brachial artery accompanied by an ulnar nerve with two roots. J Anat. 1999;195:471-6.
Suganthy J, Koshy S, Indhrasingh I, Vettivel SJ. A very rare absence if Radial artery: A case report, Anat. Soc India. 2002;51(3):61-4.
Omer FD, Musturay K, Umit D, Deniz A, Aytekin B, Erkmen B. Assessment of radial artery and Hand circulation by computed Tomography Angiography: A pilot study. Heart Surg Forum. 2004;8(1):28-32.
Dnezic PM, Cirkovic M, Knezevic A, Navokanovic A, Gojkovic-Bukarica L, Jovic M et al. The radial artery for coronary aertery bypass Grafting. ACI. LII:11-19.
Chandini G, Vikram P, Murlimanju BV, Vaishali RS. A Morphological study of variations in the Origin and Course of Radial Artery. Res J Pharmac Biol Chem Sci. 2002;3(2):333.
Sharadkumar PS. The Anatomical Study of Variant Superficial Palmar Arch. Int J Curr Sci. 2013;6:101-6.
Prakash KG, Saniya K. A study of Radial artery in cadavers and its clinical importance. Int J Med Res Heal Sci. 2014;3(2):254-62.
Nitin RM, Manisha RD. Morphometric study of radial artery. Int J Recent Trends. 2015:15(1):6-10.
Baral P, Koirala S, Baral R, Bhattacharya S, Jha CB, vijayabhaskar P. A series of study of Anatomical Variation on Arterial system of Upper limb in Nepalese Cadavers. 2008;1-9.
Ileana D, Marginean OM, Dumitrescu TH, Baluta MV. Anatomical variations of the Origin, Course and Distribution Area of The Radial Artery. Curr Heal Sci J. 2010;36(4):213-5.
Padma V, Hiren C, Dharati K, Shalieshkumar N, Saiyad SS, Chintan L. Higher bifurcation of Brachial artery with Superficial course of radial artery in forearm: A case Report. Int J Med Sci Pub Heal. 2013;2(3):703-6.
Al Talawah W, Getachew D, Soames R. The Clinical significance of Radial artery morphology in artificial arterio¬venous fistula for haemodialysis. Indian J Sci Res. 2015;11(1):24-9.
Bondage V, Balaji AM, Gangane SD. A case report on high origin of radial artery. Int J Anatomy Res. 2014;2(3):503-6.
Madhyastha S, Murlimanju, Jiji PJ, Saralaya VV, Rai A, Vadgaonkar R. Morphological Variants of the Human Superficial Palmar Arche and their clinical implications. J Morphol Sci. 2011;28(4):261-4.
Vijaya LK, NarasingaRoa B. Variations in the superficial palmar arch. Int J Basic Appl Med Sci. 2012;2(2):271-4.
Taguil SM, Cicekcibasi AE, Tunc CO, Mustafa B, Ahmet S. Variations and Clinical importance of Superficial palmar arch. Tip Fak Derg. 2007;14(2):11-6.
Loukas M, Holdman D, Holdman S. Anatomical variations of Superficial and Deep Palmar Arches. Folia Morphol. 2005;64(2):78-83.
Salgado S. Anatomical variations of the superficial palmar arch in Sri Lankan-A cadaveric study, Proceedings of annual research symposium. University of Kenya. 2009;143-4.
Ramakrishnan V, Reddy AKY, Aruna S, Thotakura B, Ananthi S. A cadaveric study onanatomical variations of the superficial palmar arch. Int J Heal Sci Rese. 2014;3(1):144-8.
Shrestha R, Banstola D. A Series of Study of Anatomical Variation On The Arterial System Of Upper Limb In Nepalese cadavers. 2002;12(2):24-9.
Russel T Woodburne, Essentials of Human anatomy, 1957:113-114,130-131
Coleman SS, Anson BJ. Arterial pattern in hand. Surg Gynec Obst. 1961;113:409-24.
Naoyukiyokoyama, Takeshita S, Ochial M, Koyama Y, Hoshino S, Isshiki T et al. Anatomic Variationofthe Radial Artery in Patients Undergoing Trans radial coronary Intervention. Catheterization cardiovascular interventions. 2002;49:357-62.
Suman U, Jayanthi KS. A study of complete superficial palmar arches formed entirely by ulnar artery. J Anat Soc Ind. 2011;60(2):199-201.
Soubhagya R, Nayak, Krishnamurthy A, Ramanathan L, Prabhu LV. The median radial type of Superficial palmar arch: A case report and review of literature. Clinics. 2008;63:409-10.
