Morphology and Variations of Brachial Artery in Cadavers

Abstract

Background: The study of brachial artery is an important arterial conduit from the clinical point of view to anatomists, general surgeons, radiologists, plastic surgeons, and even cardiovascular thoracic surgeons in the conduct of reparative surgery.Therefore, the present study was designed to study the course, branching pattern and termination of Brachial Artery and its clinical significance of these variations. Materials and Methods:The present study was conducted on 30 upperlimbs of 15 cadavers embalmed & belonging to theDepartment of Anatomy, Govt. Medical College,Alappuzha over the period of 1 year. By conventional dissectionmethod a longitudinalincision was given along the midline of arm through the deep fascia, inferiorup to cubital fossa. Brachial artery was identified, cleaned & dissected and assessed the length of brachial artery, level of termination of brachial artery, variation in the branching pattern and the course in relation to the median nerve was noted. Results:The average length of the brachial artery was 25.23 cms. 73.3% of the brachial artery followed the classical pattern as given in Gray's Anatomy. Variation in the branching pattern, presence of accessory brachial artery, origin of profunda brachial artery was noted. 3.3% trifurcation of brachial artery into Radial, Ulnar & Common interosseous at the level of neck of radius.Brachial artery terminated at the level of neck of radius in 76.67%, radial tuberosity13.33%, mid arm3.33%, proximal arm 6.67%. Discussion and Conclusion:Variationsof brachial artery in its relationship with the median nerve, pattern and level of termination are common. These may complicate arm surgical exposure, flap and vascular surgery. Hence, Knowledge of possible variations in the branching pattern of various arteries is important during vascular and reconstructive surgery.

Anatomical variation of high brachial artery bifurcation: A case report

“…In India, 30 specimens were dissected, then it was reported that the brachial artery in the third middle part gives a branch. The accessory brachial artery was in one case (3.3%) among the 30 limbs, then trifurcation of the brachial artery was also seen in 1 case (3.3%) into Radial Artery, Ulnar Artery, Common interosseous Artery [10], which is different from the current case where the Brachial artery bifurcated in the proximal third of the arm. Jacomo et al in 2014 in São Paulo and Eyni in 2016 reported similar cases in which the Brachial artery bifurcation was observed in the proximal portion of the middle third of the arm, forming lateral and medial branches.…”

Higher Termination of Brachial Artery in Cadavers in the Department of Anatomy of a Medical College: A Descriptive Cross-sectional Study

“…Other variations related to brachial artery reported are duplications, superficial brachial artery, accessory brachial artery, dilated tortuous brachial artery and trifurcations. 2,18 These variations may have occurred due to multiple plexiform sources, crossed haemodynamic predominance between primitive deep and superficial arterial segments and regression of arterial segments that have minor haemodynamic significance. 2 Such unexpected variations during routine clinical and surgical procedure may cause hazards.…”

“…The superficial radial artery may be mistaken for vein causing reflex vascular occlusion by accidental cannulation resulting in risk of gangrene. 18 A case was reported where brachial artery was explored for acute arterial insufficiency of right upper limb. Residual embolus at high bifurcating point of brachial artery was detected and thrombectomy of high originating ulnar artery was done.…”

“…19 The brachial and radial arteries are also widely used for measuring blood pressure, arterial grafting, cardiac catheterization for angioplasty and preoperative mapping for AV access in advanced and end stage renal disease. 13,18 All of these procedures may be affected by unrecognized variations in these arteries. Some studies have revealed inferior secondary and functional patency rates, frequent anastomotic lesions and non-maturation of brachio-cephalic arterio-venous fistula in patients with higher termination of brachial artery.…”

Variation in origin and course of brachial artery among black African population: Cadaveric study in Western Kenya

“…In the arm, it is superficial in its course and gives off the following branches; profunda brachii which is the largest branch and supplies triceps brachii, superior and inferior ulnar collateral (SUC&IUC) arteries, muscular branches to supply muscles of anterior compartment of the arm i.e., biceps brachii, coracobrachialis and brachialis, nutrient artery to the humerus, and terminates into the ulnar and radial arteries. (George et al, 2019;Gupta et al, 2012).…”