Patterns of the superficial veins of the cubital fossa: A meta-analysis

Abstract

Background The aim of this systematic review is to quantitatively synthesize evidence on the prevalence of superficial vein patterns in the cubital region. Method A systematic literature search was conducted through a number of electronic databases. We identified 27 studies, including 9924 arms, which met the inclusion criteria. Results Meta-analysis showed that "N" shaped arrangement type was the commonest pattern (≈44-60%) followed by "M" shaped arrangement (≈20-25%). The prevalence of "M" type and "M"-like type was significantly higher in males, whereas females showed a significant predominance of "I" or "O" type. No significant differences in various pattern types were found for laterality. The frequency of "M" type is significantly lesser in Indian and Japanese populations, but they have significantly higher frequency of "N" type. In Malay population, "I" or "O" type was significantly higher, while the brachial CV was poorly developed or missing significantly in Indian population. Conclusion This evidence-based clinical anatomy review contributes to our anatomical knowledge regarding the true prevalence of pattern types of the superficial veins in cubital region in humans and, subsequently, might help in performing safer venous access and more direct approaches to these veins, especially under emergency conditions.

A Systematic Review and Meta-Analysis of Randomized Trials Comparing Two-Stage with One-Stage Brachio-Basilic Vein Fistulas

“…We decided to include only RCTs in our meta-analysis to avoid bias related to selective use of the two-stage procedure in small basilic veins (e.g., <4–5 mm), which is nowadays a widespread practice [ 12 , 13 ], including in those patients not yet on hemodialysis having smaller basilic veins not enlarged by previous AVFs [ 14 ]. Indeed patients with the anatomical variation where the cephalic vein at the level of the antecubital fossa drains into the basilic vein [ 15 – 17 ], get significant enlargement of the latter after a functioning radio-cephalic AVF is created, at a median diameter of 7.1 mm (range, 4.5–9.2 mm) in one study [ 8 ], and future BBVF staging is not required under those circumstances.…”

The Superficial Venous System of the Forelimb of the Anubis Baboon (Papio anubis): The Distribution of Perforating Veins and Venous Valves

“…In Cercopithecoidea , a perforator that runs into deep veins around the triceps was also described, which is similar to our observations regarding the Anubis baboon. In the human, in the cubital fossa, a well-developed system of perforators was described [6, 8, 12–14, 23]. In all cases examined in our study, the main cubital perforator was found with a regulatory apparatus (single venous valves) to favor the inflow of the blood to the deep veins.…”

“…Detailed knowledge on the role of perforating veins and various limb venous valves has increased significantly over the past few decades. In relation to humans, research in this area is focused to a large extent on clinical issues: etiology and surgical treatment of lower extremity varicose veins, role of veins in the design of flaps based on their vascularization, upper limb replantations in reconstructive surgery, and venous grafting [6, 8–14]. In the field of comparative anatomy of the forelimb veins of primates, in addition to the general anatomical descriptions, we found only a few studies on the distribution of perforating veins and venous valves in the upper limbs [1].…”

Elbow AVF configurations and indications

“…In a recent meta-analysis, Yammine and Eric (6) found four major (Fig. 1) and two minor patterns; Type 1, also called the “M” (or “Y” or classical).…”