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Upper limb principal arteries variations: A cadaveric study with terminological implication.

Marek Konarik1, Vladimir Musil2, Vaclav Baca3

  • 1Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Department of Histology and Embryology, Third Faculty of Medicine, Charles University, Prague, Czech Republic.

Bosnian Journal of Basic Medical Sciences
|April 29, 2020
PubMed
Summary

This study clarifies upper limb artery variations in 423 cadavers, proposing new classification systems for axillary artery branches and free upper limb arterial trunks. Accurate terminology is crucial for safe medical procedures.

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Area of Science:

  • Anatomy
  • Vascular Anatomy
  • Human Anatomy

Background:

  • Variability in upper limb arteries presents clinical challenges due to inconsistent prevalence data and complex classification.
  • Existing terminology for arterial variations is often unclear, inappropriate, or misleading, complicating clinical understanding and application.
  • Accurate anatomical knowledge is vital for interventional procedures and surgical techniques involving upper limb vasculature.

Purpose of the Study:

  • To investigate the prevalence of anatomical variations in the axillary, brachial, and forearm arteries in a Central European population.
  • To propose standardized classification systems for axillary artery branching and major upper limb arterial trunk variations.
  • To provide precise terminology for variant arterial patterns to enhance safety in vascular interventions and surgery.

Main Methods:

  • Anatomical cadaveric study involving 423 upper limbs preserved using the formaldehyde method.
  • Systematic dissection and analysis of the arteries within the axilla, arm, and forearm.
  • Application of proposed classification systems: the Equality system for axillary artery branches and the Rodríguez-Niedenführ system for free upper limb arterial trunks.

Main Results:

  • The Equality system identified prevalence rates for axillary artery variations: Truncus subscapulocircumflexus (22.9%), truncus profundocircumflexus (13.75%), and truncus bicircumflexus (13.95%).
  • The Rodríguez-Niedenführ system identified prevalence for free upper limb arterial trunk variations: Arteria brachialis superficialis (9.5%), arteria brachioradialis superficialis (6.4%), arteria brachioulnaris superficialis (1.9%), arteria brachiomediana superficialis (0.5%), and arteria comitans nervi mediani manus (3.3%).

Conclusions:

  • The proposed classification systems offer a clearer and more consistent approach to describing upper limb arterial variations.
  • Accurate identification and terminology of these arterial variants are essential for the safe execution of catheterization and flap-based surgical procedures.
  • This study provides crucial prevalence data for variant vessels, aiding clinicians in preventing complications and managing unexpected anatomical findings.