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DeCarlo B, MacPherson E, Williams A, Bale L, MacKenzie L. Unilateral identification of a rare superficial brachioulnoradial artery contributing to the superficial palmar arch and brachial artery continuing as the interosseous artery: a case report. Surg Radiol Anat 2024; 46:495-500. [PMID: 38480592 DOI: 10.1007/s00276-024-03332-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 02/23/2024] [Indexed: 04/05/2024]
Abstract
The occurrence of variations in human arterial branching of the upper limb has been commonly reported in peer-reviewed literature. However, the variability of upper limb arterial patterns may be underappreciated in medical practice, which can result in clinical and surgical errors. Here we report a case of a rare, unilateral arterial variation of the left upper limb of a 76-year-old Caucasian male cadaver, discovered during a routine educational dissection. Observed characteristics of the variation include a high brachial artery bifurcation into a superficial brachioulnoradial artery and brachial artery continuing as the interosseous artery and then a bifurcation of the superficial brachioulnoradial artery into a superficial radial and a superficial ulnar artery, which eventually contribute to the formation of the superficial palmar arch. The anatomical characteristics, prevalence, embryological origin, and clinical significance of the variation are discussed.
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Affiliation(s)
- Brooke DeCarlo
- Anatomical Sciences Program, Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada.
- Education Program in Anatomy, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
| | - Emily MacPherson
- Anatomical Sciences Program, Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
- Yellowstone Pathology Institute, Billings, MT, USA
| | - Andre Williams
- Anatomical Sciences Program, Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
- Division of Anatomy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Logan Bale
- Anatomical Sciences Program, Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - Leslie MacKenzie
- Anatomical Sciences Program, Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
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Muradyan OA, Yotova NI. Duplicate Radial Artery Variation: A Comprehensive Analysis With Case Report, Literature Review, Embryological Insights and Clinical Significance. Cureus 2024; 16:e56976. [PMID: 38665702 PMCID: PMC11045173 DOI: 10.7759/cureus.56976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
Thorough knowledge of the anatomical variations of the arterial pattern of the upper limb is of high clinical importance in many medical fields, from surgery to nursery and anesthesiologic practice. During a routine dissection at the Anatomy Department of the Medical University of Plovdiv, a rare variation of the vascular system in the upper limb of a study cadaver was observed. The exhibited variation was the occurrence of a brachioradial artery (BRA) that ran along the main axis of the arm, superficially to the median nerve. After dissection of the cubital fossa, an unusually underdeveloped radial artery was also spotted. Per our knowledge, such a type of duplicate radial artery, the coexistence of a BRA and an underdeveloped radial artery has not been reported in the relevant literature on the topic. The underdeveloped radial artery gave a major branch, the recurrent radial artery, a branch usually given by the brachial artery or the BRA in case of a BRA variation. Variations in the arterial pattern could potentially give insight into the features of the embryological development of the vascular system.
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Affiliation(s)
| | - Nina I Yotova
- Anatomy Department, Medical University of Plovdiv, Plovdiv, BGR
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Jangir K, Singh BR, Nair N, Badge A. An Unusual High Bifurcation of the Brachial Artery: A Cadaveric Case Report. Cureus 2024; 16:e55681. [PMID: 38586801 PMCID: PMC10997832 DOI: 10.7759/cureus.55681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 03/06/2024] [Indexed: 04/09/2024] Open
Abstract
The human vascular system exhibits a remarkable degree of anatomical variability, with deviations from conventional arterial branching patterns occasionally encountered. Among these variations, the atypical bifurcation has drawn attention for its infrequent occurrence and potential clinical implications. This study investigates the rare anatomical variation of high bifurcation seen during cadaver dissection in the brachial artery. It emphasizes the relevance of understanding such variations in established vascular anatomy and their clinical implications. Detailed findings from the dissection of the upper limbs, which reveal a high bifurcation in a 40-year-old male cadaver, are presented. The report highlights unique anatomical variations, including a superficial path. The conclusion underscores the rarity of this high bifurcation and its potential impact on medical procedures. It stresses the importance of healthcare professionals being aware of and prepared for such anatomical variations for optimal patient care. In order to manage potential difficulties during medical operations affecting the circulatory system and eventually enhance patient outcomes, it is necessary to understand these deviations.
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Affiliation(s)
- Kanchan Jangir
- Anatomy, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Brij Raj Singh
- Anatomy, Datta Meghe Institute of Medical Sciences, Nagpur, IND
| | - Nancy Nair
- Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Ankit Badge
- Microbiology, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
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Glin M, Zielinska N, Ruzik K, Karauda P, Konschake M, Olewnik Ł. Morphological variations of the brachial artery and their clinical significance: a systematic review. Surg Radiol Anat 2023; 45:1125-1134. [PMID: 37530816 PMCID: PMC10514101 DOI: 10.1007/s00276-023-03198-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 06/28/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE Morphological variations of the brachial artery are quite commonly discovered in routine dissection and have been the subject of many studies. However, there is a need for a clear classification. This work presents morphological variations of the brachial artery, based on numerous case reports and studies created for the appropriate classification and interpretation among surgeons and radiologists. It also discusses the most important clinical aspects of the given varieties. METHODS The research method is based on the combined interpretation of the researches based on numerous publications concerning both the principles of correctly classifying the described morphological variations of the brachial artery and the resulting clinical implications. This work considers atypical variations such as the presence of the superficial brachial artery, brachoradial artery, accessory brachial artery and absence of the brachial artery. Variations of the brachial artery in relation to the external and internal diameter of the vessel have also been discussed. RESULTS After conducting a complex analysis of the collected data, the fundamental principles for classifying such variability as superficial brachial artery, brachioradial artery and accessory brachial artery were defined. Additionally, clinical implications resulting from the above like the impact of the superficial brachial artery on the median nerve neuropathy and the positive correlation between the brachioradial artery and increased danger of incorrect transradial catheterization were demonstrated. CONCLUSIONS The clinical implications of the atypical arterial pattern within the upper limb are crucial during the angiography and surgical procedures so the variations affect the appropriate diagnosis and surgical intervention. Hence, the knowledge about the morphological variations of the brachial artery should be constantly broadened by radiologists and surgeons to improve the accuracy and effectiveness of the treatment process.
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Affiliation(s)
- Marcin Glin
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Lodz, Poland
| | - Nicol Zielinska
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Lodz, Poland
| | - Kacper Ruzik
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Lodz, Poland
| | - Piotr Karauda
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Lodz, Poland
| | - Marko Konschake
- Department of Anatomy, Histology and Embryology, Institute of Clinical and Functional Anatomy, Medical University Innsbruck (MUI), Innsbruck, Austria
| | - Łukasz Olewnik
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Lodz, Poland
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Ruze A, Amuti S, Abuduzayier A, Liu F. Variant formation and branching pattern of superficial palmar arch in a human cadaver: a case report. Anat Sci Int 2023; 98:147-150. [PMID: 36197651 DOI: 10.1007/s12565-022-00685-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 09/17/2022] [Indexed: 01/20/2023]
Abstract
Superficial palmar arch (SPA) is a dominant vascular structure in the palmar region that provides a major blood supply to fingers. Present case describes a rare formation and branching pattern of SPA in a formalin fixed cadaveric left hand. In this case, SPA was formed by the anastomoses between radial artery (RA) and the superficial brachioulnar artery (SBUA), which is defined as an ulnar artery with a high origin in the arm. More interestingly, unlike classic literature, SPA sends out six branches instead of four, and the principle artery of thumb arises directly from SPA instead of RA. The aforementioned variations have rarely been reported in previous literature and demonstrate important clinical significance for accidental intra-arterial injections, errors in blood pressure readings, as well as orthopedic, plastic and vascular surgeries of the upper limbs.
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Affiliation(s)
- Abudureyimujiang Ruze
- Department of Human Anatomy, School of Basic Medical Science, Xinjiang Medical University, 567 Shangde North Road, Ürümqi, 830011, Xinjiang, People's Republic of China
| | - Siyiti Amuti
- Department of Human Anatomy, School of Basic Medical Science, Xinjiang Medical University, 567 Shangde North Road, Ürümqi, 830011, Xinjiang, People's Republic of China
| | - Abulizi Abuduzayier
- Department of Pharmacy, The First People's Hospital of Xinjiang Kashi Area, Kashi, 844000, Xinjiang, China
| | - Fengxia Liu
- Department of Human Anatomy, School of Basic Medical Science, Xinjiang Medical University, 567 Shangde North Road, Ürümqi, 830011, Xinjiang, People's Republic of China.
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Shetty H, Patil V, Mobin N, Gowda MHN, Puttamallappa VS, Vamadevaiah RM, Kunjappagounder P. Study of course and termination of brachial artery by dissection and computed tomography angiography methods with clinical importance. Anat Cell Biol 2022; 55:284-293. [PMID: 36168778 PMCID: PMC9519768 DOI: 10.5115/acb.22.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 05/09/2022] [Accepted: 05/12/2022] [Indexed: 11/27/2022] Open
Abstract
The Brachial artery is a continuation of the axillary artery, from the inferior border of the tendon of teres major to the neck of the radius, terminating into radial and ulnar arteries just a cm distal to the elbow joint. Unlike veins, variations in the arteries are comparatively less common. Anatomical variations of the brachial artery occur in almost 20% of the cases and are commonly found during routine dissection or clinical practice. To observe the variations in the course and termination of brachial artery by dissection and computed tomography (CT) angiography methods. The present study was conducted on 40 upper limbs each in the department of Anatomy & Radiology of JSS Medical College and Hospital, Mysuru. The brachial artery was traced from origin to termination and variations were noted and photographed. Patients who were undergoing CT angiography of the upper limbs in JSS Hospital were included in the study. Variations noted and compared with the dissection method. In the present study, normal patterns of the brachial arterial course and termination were observed in 31 specimens. The remaining 9 specimens showed variant course and termination in the brachial artery like an unusually tortuous superficial brachial artery, superficial brachio-ulnar artery and brachio-radial artery. CT angiography showed 6 variations and a tortuous brachial artery. A detailed description of the vascular pattern of upper limbs especially variations in their origin and termination is of extreme importance in clinical practice. The knowledge of these variations is important for catheterization, graft harvesting, arteriovenous fistula creation, shunt application and astrup examination.
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Affiliation(s)
| | - Vikram Patil
- Department of Radiology, JSS Hospital, Mysuru, India
| | - Najma Mobin
- Department of Anatomy, JSS Medical College, JSS AHER, Mysuru, India
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Multiple arterial variations in the upper limb: description and clinical relevance. Anat Sci Int 2020; 96:310-314. [PMID: 32909194 DOI: 10.1007/s12565-020-00569-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
Although arterial variations in the upper limb are usually found during anatomical dissections and clinical practice, multiple arterial variations associated with nervous variations along the limb is rare and clinically relevant. This paper described a combined anatomical variation involving the neurovasculature in the upper limb. A left upper limb dissection of a male cadaver with approximately 50-60 years of age, fixed in 10% formalin, was performed. During the dissection was observed, the brachial artery ending in the middle third of the arm in three branches: a nutritional branch for the biceps brachii muscle, a "lateral brachial artery" and a "medial brachial artery", which became, after unusual paths crossing over the cubital fossa, the ulnar artery and the radial artery, respectively. Radial and ulnar artery demonstrated several unusual anastomotic branches, respectively, and an anastomotic arch around the biceps brachii muscle tendon. Such combined anatomical variation is unique and relevant for clinical and surgical practice.
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