Morphological and imaging evaluation of the upper limb arteries variability

Abstract

Introduction. The need for a deep morphological study on the issue of variability of the upper limb arteries is dictated by the modern requirements of practical medicine, as the number of surgical interventions, therapeutic and diagnostic procedures on the upper limbs have lately considerably increased. Aim of the study. Identification and description of morphological variability of the upper limb arteries by means of classical dissection and imaging methods dependent on age, gender and side of the body. Materials and methods. The study was performed at the Chair of Human anatomy of Nicolae Testemitanu SUMPh, on 26 formalin-treated upper limbs of adult cadavers (7 of those were bilaterally dissected) and on 34 CT angiographies performed on the device Light speed VCT 64 slides, from the database of the archives of the Euromed Diagnostic Medical Center. The study was carried out on 25 male and 21 female between the ages of 55-70. The macroscopic study was performed according to the anatomical dissection method by Vorobiov V. P., as a result of which the arteries of the upper limb with terminal and collateral branches were highlighted. The imaging study using the angio-CT method enabled us to establish the real topography of the main arteries and their branches, and the 3D reconstruction revealed their origin. Results. The following arterial variants were identified by anatomical dissection carried out on 14 upper limbs, 9 of those samples were dissected on male cadavers (6 right and 3 left) and 5 on female cadavers (3 right and 2 left). In 3 cases only one arterial variant was determined, whereas at the remaining 11 samples there were multiple variations (about 2-3), revealed bilaterally in 3 and unilaterally in 12 cases. The most variable artery of the upper limb proved to be the brachial artery in 18 cases; numerical variants of the collateral branches – 6 cases; variants of high origin of its terminal branches – 3 cases; presence of common arterial trunks – 4 cases; there were marked out 4 atypical topographical variants and 1 case of brachial artery trifurcation. The axillary artery with branching variants was detected in 9 male and 3 female upper limbs; the bilateral presence was determined in 2 cases and unilateral in 10 (6 right and 4 left); among variants the numerical and common trunks prevalence was highlighted. The angiographic study pointed out anatomical variants in 12 cases; mostly in males (10 cases) and predominantly on the right – 7; the most common was high bifurcation of the brachial artery and common arterial trunks. Conclusions. The variants of the upper limb arteries have undoubted practical significance for diagnostics and surgical management.