Some anatomical variants of the arteries of the upper limb

Abstract

Introduction. The study of individual variability is a large division of anatomy and one of the current directions of modern morphology. Many errors in medical practice are caused by the ignorance of anatomical variants. Radiologists may mistakenly confuse and interpret angiographic images with such vascular patterns, and surgeons may encounter difficulties during surgery at this level. Aim of the study. Morphological and imaging evaluation of variations of the brachial artery (BA) branching pattern. Materials and methods. A retrospective, descriptive study of BA was carried out on 70 upper limbs (UL) of formalized adult cadavers, dissected at the Department of Human Anatomy of Nicolae Testemitanu SUMPh, and on 183 angiographies, taken from the database of the Medical Center Euromed Diagnostic, and from the Department of Interventional Radiology, Angiography of MSPI MCH Sfânta Treime, from Chisinau, Republic of Moldova. Using the method of fine anatomical dissection and the analysis of angiographic records, the branching pattern of BA at the level of its terminal branches was followed. Results. The atypical branching pattern of BA was determined in 21 UL (8.3%). The identified cases were divided into 5 groups: 1) high bifurcation of BA, found in 2.7% (7 UL: in 4 UL it was visualized in the middle third of the arm; in 1 UL - at the level of the retropectoral portion of the axillary artery (AA); in 1 UL - in the upper third of the arm and in another UL - in the lower third of the arm); 2) BA trifurcation, established in 2% (5 UL: in 4 UL the brachial artery trifurcated into the radial, ulnar and radial recurrent arteries, and in another limb - into the radial, ulnar and common interosseous arteries); 3) high origin of the ulnar artery, 2% (5 UL: in 3 UL it started from AA, and in the other 2 - from BA, in the upper third of the arm); 4) high origin of the radial artery, 1.2% (3 UL: in 2 UL it started from BA, in the upper third of the arm, and in another limb - from AA); 5) the presence of superficial BA - 0.4% (in 1 UL, this artery started from the retropectoral portion of AA, while in the lower third of the arm it anastomosed with BA). Conclusions. The origin and course variation of BA are of major practical importance for both radiologists and vascular surgeons.