Origen alto de la arteria radial (Arteria braquirradial superficial): Presentación de 3 casos / High origin of the radial artery (superficial brachialarterial artery): Presentation of 3 cases

Se presentan tres casos de nacimiento alto de la arteria radial, todos en el miembro derecho, uno a nivel del tercio superior de la arteria braquial, el segundo caso a nivel del tercio medio de la misma y en el tercer caso el nacimiento de la arteria radial se produce a nivel de la arteria axilar. En todos los casos tienen un trayecto superficial en el brazo y antebrazo. En la mano forman el arco palmar arterial profundo de manera habitual. Estos casos representan el 7,5% de los 40 miembros disecados. El origen alto de la arteria radial es la variante más frecuente dentro de las anomalías del árbol arterial del miembro superior. Su importancia radica en el aumento de los procedimientos percutáneos sobre la arteria radial en cateterismos coronarios y en el cada vez más utilizado colgajo radial en las cirugías reconstructivas. Su trayecto superficial favorece los traumatismos y la confusión con venas, situación que puede ocasionar inyecciones medicamentosas accidentales en estas arterias con sus graves consecuencias.

We present three cases of high birth of the radial artery, all on the right limbone at the upper third of the brachial artery, the second at the middle third of the artery, and in the third case the radial artery arises at the level of the axillary artery. In all cases they have a superficial path in the arm and forearm. In the hand they form the deep arterial arch of the palmar in the usual way. These cases represent 7.5% of the 40 dissected members. The high birth of the radial artery is the most frequent variant within the arterial tree anomalies of the upper limb. Its importance lies in the increase of the percutaneous procedures on the radial artery in coronary catheterisms and in the increasingly used radial flap in the reconstructive surgeries. Its superficial pathway favors trauma and confusion with veins, a situation that can cause accidental drug injections in these arteries with their serious consequences.

High Origin of Radial Artery- A Cadaveric Case Report.

Variations in the arterial pattern of the upper limb are very common as observed in many cadaveric and angiographic studies. Knowledge of variations in the origin and course of the radial artery is important because they are used for many diagnostic procedures as well as vascular and reconstructive surgeries like coronary angiography, percutaneous coronary intervention and coronary artery bypass surgery. During routine dissection in our institute, we observed a case of high origin of the radial artery in a 33 year old male cadaver. It was found to be unilateral; on left side, radial artery was taking origin from 3rd part of the axillary artery at the lower border of pectoralis minor before the origin of subscapular artery and anterior circumflex humeral artery. It had a superficial course in the arm crossing the median nerve from medial to lateral side. The further course of this superficial radial artery in the forearm was normal and it terminated by forming a deep Palmar arch in hand. These variations may be of great clinical implications for vascular and plastic surgeons and radiologists. Superficial course of radial artery makes it vulnerable to accidental injuries and elevates the risk of bleeding.

Implicancias clínico-quirúrgicas del origen alto de la arteria radial / Clinical and surgical implications of the radial artery high origin

Las variaciones arteriales del miembro superior tienen su justificación en el origen embriológico. El nacimiento de la arteria radial por proximal a la interlínea articular del codo es una de las variaciones anatómicas más frecuentes y su importancia radica en el aumento de los procedimientos percutáneos sobre la arteria radial en cateterismos coronarios y en el cada vez más utilizado colgajo radial en las cirugías reconstructivas. Su trayecto superficial favorece los traumatismos y la posibilidad de confusión con las venas puede ocasionar la realización de inyecciones medicamentosas accidentales en estas arterias con sus graves consecuencias. El conocimiento de las variaciones arteriales del miembro superior, y en especial de la arteria radial presentada en esta investigación, es fundamental al momento de planear abordajes clínicos y quirúrgicos que los involucre.

The upper limb arterial variations are justified by the embryological origin of all the limb. The birth of the radial artery above the joint line of the elbow is one of the most frequent anomalies and its importance is increasing in percutaneous procedures on the radial artery, in coronary catheterizations and the increasingly used of the ra- dial flap in reconstructive surgery. Its superficial way favors injuries and the possibility of confusion with veins that can cause accidental drug performing injections in these arteries with serious consequences. Knowledge of arterial variations of the upper limb, especially the radial artery presented in this research, is essential when planning clinical and surgical approaches that involves them.

Relationship Between the Facial Artery and Sub Mandibular Salivary Gland.

Knowledge of relationship between the facial artery and submandibular salivary gland is essential for the surgeon operating in the submandibular region. This study has been under taken to have the knowledge of this relationship. Submandibular region has been dissected on 20 male cadavers in the Department of Anatomy, Sree Narayana Institute of Medical Sciences, Kerala. The course of the facial artery and its relationship to submandibular salivary gland has been followed carefully. The standard description of ascent of the facial artery along the entire length of posterior border of the submandibular salivary gland was seen in 15 out of the 20 sides studied. In 4 out of 20 sides dissected the facial artery reached only the upper part of the posterior border of the gland. The facial artery arose high on the external carotid artery near the angle of the mandible in one specimen. It reached the gland only at its postero-superior angle, pierced through the gland and emerged on the upper part of the lateral surface of the gland. Our study shows that only 1/5 of instances facial artery courses along the posterior border of the gland. In 4/5 of instances it reaches only the upper part of the posterior border.

Analysis of the Height of Origin of Profunda Femoris Artery from the Femoral Artery with regards to the Inguinal Ligament.

Background and aims: To determine the place of height of origin of profunda femoris artery from the femoral artery with regards to the inguinal ligament. Materials and methods: Routine dissection of 6 formalin fixed cadavers (3 males and 3 females) on both lower limbs (totally 12 lower limbs) allotted for the first year students of Kanyakumari Government Medical College, Aasaripallam, Nagercoil. Result: Among them an unusual origin of profunda femoris artery was observed on the left lower limb in a 60 years old female cadaver (8.33%). The profunda femoris artery arose laterally about 0.5 cms from the femoral artery distal to the inguinal ligament. It arose normally on the right lower limb(3.5 cms from the inguinal ligament). Conclusion: A variance in height of origin of profunda femoris artery and its branches will cause changing in the calibers strongly influencing vascularisation quality of belonging flaps. In occlusion of the superficial femoral artery, the profunda femoris artery forms an effective collateral bed between iliofemoral segment and the popliteal artery and its branches. Percutaneous femoral artery cannulation can cause pseudo aneurysms. When this occurs the puncture site is frequently in the profunda femoris artery, where anatomic relationships make hemostasis difficult to achieve. These complications landed up in the study of relations of these arterial complications in the palpable landmarks.

A Case Report on High Origin of Radial Artery.

Background: The use of radial artery (RA) as an access to heart and for other procedures and surgeries make it significant. The context and purpose: The RA is a common access port for coronary angiography (CAG), percutaneous coronary intervention (PCI), and coronary artery bypass graft Surgery (CABG), RA cannulation, along with others. Results: In this case report, we want to present a case of unilateral high origin of RA arising as branch of brachial artery in the proximal 1/3rd of arm. Conclusions, brief summary and potential implications: Misdiagnosis, complications during medical procedures and increased possibility of injury are the most common dangers of having a superficial RA.