ABSTRACT
Background: The study of brachial artery is an important arterial conduit from the clinical point of view toanatomists, general surgeons, radiologists, plastic surgeons, and even cardiovascular thoracic surgeons in theconduct of reparative surgery.Therefore, the present study was designed to study the course, branching patternand termination of Brachial Artery and its clinical significance of these variations.Materials and Methods: The present study was conducted on 30 upperlimbs of 15 cadavers embalmed & belongingto theDepartment of Anatomy, Govt. Medical College,Alappuzha over the period of 1 year. By conventionaldissectionmethod a longitudinalincision was given along the midline of arm through the deep fascia, inferiorupto cubital fossa. Brachial artery was identified, cleaned & dissected and assessed the length of brachial artery,level of termination of brachial artery, variation in the branching pattern and the course in relation to themedian nerve was noted.Results: The average length of the brachial artery was 25.23 cms. 73.3% of the brachial artery followed theclassical pattern as given in Gray’s Anatomy. Variation in the branching pattern, presence of accessory brachialartery, origin of profunda brachial artery was noted. 3.3% trifurcation of brachial artery into Radial, Ulnar &Common interosseous at the level of neck of radius.Brachial artery terminated at the level of neck of radius in76.67%, radial tuberosity13.33%, mid arm3.33%, proximal arm 6.67%.Discussion and Conclusion: Variationsof brachial artery in its relationship with the median nerve, pattern andlevel of termination are common. These may complicate arm surgical exposure, flap and vascular surgery.Hence, Knowledge of possible variations in the branching pattern of various arteries is important during vascularand reconstructive surgery.
ABSTRACT
A detailed description of the vascular pattern of upper limbs especially their variations in their origin, course and branching pattern is of utmost importance anatomically in general and clinically in particular. These variations have drawn attention of surgeons, physicians, radiologists and interventionists due to the advanced surgical procedures practiced in vascular surgeries, plastic (reconstructive) surgeries and also for diagnostic and therapeutic approaches. 50 cadavers (100 upper limbs) were used for the study, which were dissected as the part of routine dissection for teaching undergraduate students at our institution. Length of the normal and variant arteries with mean, standard deviation, 'p' and 't' values are noted in each of the limbs. The following variations are observed: i) high division of brachial artery, ii) higher origin of profunda brachii artery, iii) high origin of radial artery, iv) absence of common interosseous artery. The variations are of particular importance to the surgeons operating in the area, especially for those involved in vascular reconstructive surgeries. So it is prudent to do pre-operative studies of the brachial and antebrachial arteries and their branching patterns, to prevent possible complications post operatively.
Una descripción detallada del patrón vascular de los miembros superiores, especialmente sus variaciones en el origen, curso y patrón de ramificación son de suma importancia anatómica en general y clínica en particular. Estas variaciones han llamado la atención de los cirujanos, médicos, radiólogos e intervencionistas debido a los procedimientos quirúrgicos avanzados practicados en cirugía vascular, cirugía plástica (de reconstrucción) y también para los métodos diagnósticos y terapéuticos. 50 cadáveres (100 miembros superiores) se utilizaron para el estudio, los que fueron disecados como parte de una disección de rutina para la enseñanza de los estudiantes de pregrado en nuestra institución. La longitud de las arterias normales y variantes con su media, desviación estándar, valores "p" y "t" se observaron en cada uno de los miembros. Las siguientes variaciones se observaron: i) división alta de la arteria braquial, ii) origen alto de la arteria braquial profunda, iii) origen alto de la arteria radial, iv) ausencia de la arteria interósea común. Las variaciones son de particular importancia para los cirujanos que operan en la zona, especialmente para quienes participan en cirugías de reconstrucción vascular. Por lo tanto, es prudente hacer estudios pre-operatorios de las arterias braquial y antebraquiales y sus patrones de ramificación, para evitar posibles complicaciones post-operatorias.