DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20150154

A study of variations in brachial artery and its branching pattern

Uma Shivanal, M. S. Trinesh Gowda

Abstract


Background: Knowledge of the normal and variant arterial anatomy of the upper extremity is of significant clinical importance for the vascular radiologist and surgeons for accurate diagnostic interpretation as well as in the conduct of interventional and surgical procedures on the upper extremity. The anatomical knowledge of the anomalous branching pattern of the brachial artery is important during percutaneous arterial catheterization, so as to prevent any complications arising from accidental damage to the anomalous vessel and knowledge of the variations are important for plastic surgeons using flaps for reconstructive surgeries.  

Methods: The present study was undertaken on 50 upper limbs of both sexes from embalmed adult human cadaver used for undergraduate dissection from the department of Anatomy, Mandya Institute of Medical Sciences, Mandya.

Results: In the present study, normal brachial artery was found in 42 specimens accounting for 84%. Variations were found in 8 specimens (16%); of these five specimens presented with trifurcation of brachial artery into radial, ulnar and radial recurrent arteries (10%); one specimen presented with double profunda brachii artery (2%); one specimen showed high origin of radial artery (2%) and one specimen presented with high division of brachial artery in the proximal third of arm (2%).  

Conclusions: Accurate anatomical knowledge about the brachial artery and its branching pattern with their variations are important for physicians, cardiologists, vascular surgeons and interventional radiologists. Study of these variations and its awareness helps in avoiding the iatrogenic injuries of the blood vessels, in the management of accidental/traumatic injuries to arteries in upper limb and during diagnostic procedures (like arteriograms).

 


Keywords


Brachial artery, Brachial artery variations, Profunda brachii artery, Radial artery, Ulnar artery

Full Text:

PDF

References


Standring S, Borely NR, Collins P, Crossman AR, Gatzoulis MA, Herly JC, et al. Upper arm. In: Standring S, Borely NR, Collins P, Crossman AR, Gatzoulis MA, Herly JC, et al., eds. Gray’s Anatomy: the Anatomical Basis of Clinical Practice. 40th ed. London, UK: Elsevier Ltd; 2008: 827-828, 835-836.

Sinnatamby CS. Upper limb. In: Sinnatamby CS., eds. Last S Anatomy. 11th ed. Philadelphia: Churchill Livingstone Elsevier; 2006: 61.

Junior R, Esteves, Simoes JS, Fernandes GJM. Bilateral high division of the brachial artery in one human male cadaver: a case report. J Morphol Sci. 2011;28(3):204-7.

Krstonosic B, Srdic B, Maric D, Gudovic R, Mijatov S, Babovic S. An anatomical study of double brachial arteries - a case report. IJAV. 2010;3:6-8.

Aughsteen AA, Hawamdeh HM, AL-Khayat M. Bilateral variations in the branching pattern of brachial artery. IJAV. 2011;4:167-70.

Patnaik VVG, Kalsey G, Rajan KS. Branching pattern of brachial artery - a morphological study. J Anat Soc India. 2002;51:176-86.

Bilodi AK, Sanikop MB. Variations in termination of brachial artery - a case report. Kathmandu Univ Med J. 2004;2(1):49-51.

Malcic GJ, Gurunluogl R, Ozdogmus O, Yalin, Aymelek A. Unique case of trifurcation of the brachial artery: its clinical significance. Clinic Anat. 2002 May;15(3):224-7.

Das S, Singh S, Paul S. Double profunda brachii and abnormal branching pattern of the brachial artery. TMJ. 2005;55:159-61.

Bidarkotimath S, Avadhani R, Arunachalam K. Primary pattern of arteries of upper limb with relevance to their variations. Int J Morphol. 2011;29(4):1422-8.

Bergman RA, Thompson SA, Afifi AK, Saadeh FA. Cardiovascular system. In: Bergman RA, Thompson SA, Afifi AK, Saadeh FA, eds. Compendium of Human Anatomic Variation. Text, Atlas and World Literature. 1st ed. Baltimore: Urban and Schwarzenberg; 1988: 73-74.

Quarrat-ul-Ain, Kauser Y, Raza TA. High division of brachial artery and analogous start of radial and ulnar arteries. Ann King Edward Med Coll. 2002 Jan-Mar;8(1):30-1.

Cherukupuli C, Dwivedi A, Dayal R. High bifurcation of brachial artery with acute arterial insufficiency: a case report. Vasc Endovasc Surg. 2008;41(6):572-4.

Rodriguez-Niedenführ M, Vazquez T, Nearn L, Ferreira B, Parkin I, Sanúdo 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.

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

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

Datta AK. The circulatory system. In: Datta AK, eds. Essentials of Human Embryology. 6th ed. Kolkata, India: Current Books International; 2010: 183-185.

Rodriguez-Niedenfuhr M, Burton GJ, Deu J, Sanudo JR. Development of the arterial pattern in the upper limb of staged human embryos: normal development and anatomic variations. J Anat. 2001;199:407-17.

Rodriguez-Niedenführ M, Vazquez T, Parkin IG, Sanudo JR. Arterial patterns of the human upper limb: update of anatomical variations and embryological development. Eur J Anat. 2003;7:21-8.

Pushpalatha M, Haq I. Bilateral high division of the brachial artery - a case report. Anatomica Karnataka. 2010;4(1):59-61.