High origin of radial artery: a comparative, anatomical and embryological consideration


  • Shilpi Agarwal Department of Anatomy, Maulana Azad Medical College, New Delhi
  • Rekha Lalwani All India Institute of Medical Sciences, Bhopal, Madhya Pradesh
  • C. S. Ramesh Babu Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh




Radial artery, Seventh intersegmental artery, Superficial brachial artery, High origin


Background: Radial artery is one of the terminal branches of the brachial artery arising in the cubital fossa about 1 cm below the bend of the elbow. Diversions of the radial artery from its normal anatomical pattern as regards to its origin or its course constitute the largest group of vascular variations of the upper extremity. Unusual origin of the radial artery may cause failure of transradial approach for percutaneous coronary angiography and difficulty in the reconstructive surgery of the upper limb.

Methods: The present study was conducted in the Department of Anatomy at LLRM Medical College on 16 formalin fixed cadavers (12 male and 4 female) of adult age group i.e. 32 upper limbs. Axilla and arm was carefully dissected. Axillary artery and brachial artery were dissected and its branching pattern was observed to note the origin of radial artery. The course of radial artery was noted in each case.

Results: Radial artery took origin from the third part of the axillary artery in 3.12%. It arose 2 cm above the lower border of teres major, coursed superficial to median nerve in the arm and continued in the forearm as such. The brachial artery after giving its branches continued as ulnar artery in the forearm. In 96.88%, radial artery arose normally in cubital fossa.

Conclusions: High origin and superficial course of the radial artery may be hazardous and vulnerable to injury during venepuncture and surgical procedures. This type of anomaly is due to failure of formation of the communicating branch between superficial brachial artery and axial artery at level of elbow. Awareness about details and topographic anatomy of such variations may help to prevent diagnostic errors, influence surgical tactics and interventional procedures.



McComarck LJ, Cauldwell EW, Anson J. Brachial and antebrachial arterial patterns. Surg Gynecol Obstetr. 1953;96:43-54.

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 Anat. 2001;199:547-66.

Jurjus A, Sfeir R, Bezirdjian R. Unusual variation of the arterial pattern of the human upper limb. Anat Rec. 1986;215:82-3.

Compta XG. Origin of radial artery from the axillary artery and associated hand vascular anomalies. Journal of Hand Surgery. 1991;16(A):293-6.

Drizenko A, Maynou C, Mestdagh H, Mauroy B, Bailleul JP. Variations of the radial artery in man. Surg Radiol Anat. 2000;22:299-303.

Williams PL, Bannister LH, Collins P, Dyson M, Dussek J, Ferguson M, eds. Gray’s Anatomy. The Anatomical basis of Medicine and Surgery. 38th ed., Edinburgh, Churchill Livingstone. 1995;319:1269.

Quain R. Anatomy of the arteries of the human body. Taylor and Walton, London. 1844;326-37.

Valsecchi O, Vassileva A, Musumeci G, Rossini R, Tespili M, Guagliumi G,Mihalcsik L, Gavazzi A, Ferrazzi P. Failure of transradial approach during coronary interventions: anatomic considerations. Catheter Cardiovasc Interv. 2006;67:870-8.

Hollinshead WH. Anatomy for Surgeons. The back and limbs. In: Pectoral region, axilla and shoulder: The axilla. 1958;3:290-300.

Yang HJ, Gil YC, Jung WS, Lee HY. Variations of the superficial brachial artery in Korean cadavers. J Korean Med Sci. 2008;23:884-7.

Konarik M, Knize J, Baca V, Kachlik D. Superficial brachioradial artery (radial artery originating from the axillary artery): a case-report and its embryological background. Folia Morphol (Warsz). 2009;68:174-8.

Rodriguez-Baeza A, Nebot J, Ferreira B, Reina F, Perez J, Sanudo JR. An anatomical study and ontogenic explanation of 23 cases with variations in the main pattern of the human brachio-antebrachial arteries. Journal of Anatomy. 1995;187:473-9.

Dubreuil-Chambradrel L. L’Artere mediane. Gazette Medieale du centre, Cited by Singer E. Embryological patterns persisting in arteries of the arm. Anat Rec. 1933;55:406-13.

Icten N, Sullu Y, Tuncer I. Variant high-origin radial artery: a bilateral case. Surg Radiol Anat. 1996;18:63-6.

Okoro IO, Jiburum BC. Rare high origin of the radial artery- a bilateral, symmetrical case. Nig J Surg Res. 2003; 5: 70–72.

Waghmare JE, Tarnekar AM, Sonatakke BR, Bokariya P, Ingole IV. A high origin of radial artery with asymmetrical vasculature of upper limbs: a case report. Nepal Med Coll J. 2009;11:284-6.

Zhan D, Zhao Y, Sun J, Ling E-A, Yip GW. High origin of radial arteries: a report of two rare cases. The Scientific World J. 2010;10:1999-2002.

Balachandra N, Prakash BS, Padmalatha K, Ramesh BR. Unusual origin of the radial artery. Internat J Anatom Variations. 2011;4:101-3.

Shiny Vinila BH, Sangeeta M, Sanikop MB, Venkateshu KV. Superficial brachioradial artery with its embryological basis: a case report. International journal of basic and applied medical sciences. 2013;3(1):10-3.

Loukas M, Louis RG, Almond J, Armstrong T. A case of an anomalous radial artery arising from the thoracoacromial trunk. Surg Radiol Anat. 2005;27:463-6.

Singer E. Embryological patterns persisting in the arteries of the arm. Anat Rec. 1933;55:406-13.

Madhyastha S, Nayak SR, Krishnamurthy A, D’Costa S, Jose AA , Bhat MR. Case report of high origin of radial, ulnar, and profunda brachii arteries, its clinical implications and review of the literature. J Vasc Bras. 2009;8(4):374-8.

Wood SJ, Abrahams PH, Sanudo JR, Ferreira BJ. Bilateral superficial radial artery at the wrist associated with a radial origin of a unilateral median artery. J Anat. 1996;189:691-3.

Daimi SR, Siddiqui AU, Wabale RN. Variations in the branching pattern of axillary artery with high origin of radial artery-Case Report. Int J Anat Var. 2010;3:76-7.

Karlsson S, Niechajev IA. Arterial anatomy of the upper extremity. Acta Radiol. 1982;23:115-21.

Pelin C, Zagyapan R, Mas N, Kasabay G. An unusual course of the radial artery. Folia morphol. 2006;65(4):410-3.

Diz JC, Ares X, Tarrazo AM, Alvarez J, Meanos ER. Bilateral superficial radial artery at the wrist. Acta Anaes Scand. 1998;42:1020.




How to Cite

Agarwal, S., Lalwani, R., & Babu, C. S. R. (2017). High origin of radial artery: a comparative, anatomical and embryological consideration. International Journal of Research in Medical Sciences, 4(8), 3295–3298. https://doi.org/10.18203/2320-6012.ijrms20162282



Original Research Articles