A Brachial Artery and Its Branching Pattern - Cadaveric Study

Abstract

Background: The comprehensive knowledge of the normal and variant arterial anatomy of the upper extremity is of great significance to the vascular radiologist and surgeons for accurate diagnostic interpretation as well as in the smooth conduct of interventional and surgical procedures on the upper extremity. Anatomical knowledge of the anomalous branching pattern of the brachial artery is critical during percutaneous arterial catheterization to prevent issues from accidental damage to the anomalous blood vessel, and knowledge of the variations is critical for plastic surgeons who use flaps for reconstructive surgery. Knowledge of higher division of brachial artery is also important for all cases of traumatic amputation and revascularization techniques. It has to be remembered that the bifurcation of the brachial artery is the commonest site for embolism and a higher bifurcation would result in a larger area of ischemia than expected and the higher division seeks a greater clinical significance. Materials and Methods: The current investigation involved 50 upper limbs of both sexes from an embalmed adult human cadaver used for undergraduate dissection at Mandya Institute of Medical Sciences in Mandya. Results: The normal brachial artery was discovered in 42 specimens, accounting for 84 percent of the total. Variations were found in 8 specimens (16%); five of these had trifurcation of the brachial artery into the radial, ulnar, and radial recurrent arteries (10%); one specimen had double profunda brachii artery (2%); one specimen had high origin of the radial artery (2%); and one specimen had high division of the brachial artery in the proximal third of arm (2%). Conclusion: Physicians, cardiologists, vascular surgeons, and interventional radiologists need accurate anatomical knowledge of the brachial artery and its branching pattern, as well as their variations.  The study of these variations and their awareness aids in the prevention of iatrogenic blood vessel injuries, the management of accidental/traumatic injuries to arteries in the upper limb, and during diagnostic procedures (like arteriograms).