Variations of the radial recurrent artery of clinical interest

Abstract

The anatomy of the radial recurrent artery (RRA) is important for different clinical procedures: interventional cardiology and microsurgery of the forearm; however, few studies have analysed its morphology: number, course, relations and distribution. The RRA was analysed in 332 upper limbs divided into two groups: (1) normal pattern of the arterial axis of the upper limb (266 cases), (2) associated with major arterial variations (66 cases). A second or accessory RRA existed in 31.2% in group 1, and 30.3% in group 2. In both groups, the second RRA originated from the brachial (100%) and always (100%) coursed behind the bicipital tendon. The accessory RRA supplied the brachioradialis, brachialis and biceps brachii muscles. The RRA in group 1, originated mostly from the radial artery (75%), followed by radioulnar division and ulno-interosseous trunk. In group 2, the RRA arise from the brachioradial artery (65%), or from the radial artery (in cases of ulnar or brachial artery variation). The course of the RRA behind the biceps brachii tendon was observed in 9.4% of group 1 and in 6.1% of group 2. The RRA supplied the brachioradialis, extensor carpi radialis longus and brevis, and supinator muscles. The RRA and accessory RRA anastomosed forming a ring around the biceps brachii tendon in 0.75% in group 1 and in 13.6% in group 2, the latter group having an important clinical interest. The variability of the RRA may provide an advantage for microsurgical procedures of the elbow and disadvantage during transradial catheterism.