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Identifying Variants and Prevalence of the Superficial Brachial Artery – A Case Series
Author(s) -
Bolden Alexys M.,
Schmitt Emily A.,
Alsharaf Fatemah,
Zdilla Matthew J.,
Lambert H. Wayne
Publication year - 2020
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.2020.34.s1.06513
Subject(s) - brachial artery , medicine , anatomy , median nerve , cadaver , brachial plexus , musculocutaneous nerve , axillary artery , blood pressure
Superficial brachial artery (SBA) is the term used for when the brachial artery (BA) itself or an early branch from the BA travels superficial to the roots of the median nerve (MN) or the MN itself. The purpose of this study was to determine the prevalence of the aforementioned SBA variations, to identify early branching variants of the SBA, and to explore the appropriateness of the anatomical terminology of these SBA variants due to ambiguity in the nomenclature. Assessment of 87 cadavers (174 upper extremities) led to the discovery of nine (5.2%) SBA variations which were observed in a total of seven (8.0%) cadavers (five females, two males). Three different SBA variation types were observed: Variation 1 was identified when the entire BA ran superficial to the median nerve roots, present in 1 of 174 limbs (0.57%); Variation 2 was noted when the BA bifurcated proximal to median nerve roots, resulting in superficial brachial and brachial arteries, seen in 6 of 174 limbs (3.4%); and Variation 3, wherein the BA bifurcated distal to the median nerve roots at the location of an additional connection between the musculocutaneous and median nerves, also resulting in superficial brachial and brachial arteries in 2 of 174 limbs (1.1%). The branches of the BA were followed to discern their branching patterns distally. In the six examples described as Variation 2, four (67%) of the SBAs traveled distally to become the radial artery only (Variation 2A), and two (33%) traveled distally to become both the radial and ulnar arteries (Variation 2B). For the two examples identified as Variation 3, both of the SBA vessels turned into solely the radial arteries distally. Therefore, Variations 2A and 3 both travel distally to become solely the radial artery; however, there is confusion in the literature as to whether these SBA variants can also be called high origin radial arteries (HORAs). Therefore, clarification of the current criteria for naming these brachial artery variants will also be discussed. Due to the unusual locations of SBAs, these variant arteries may cause confusion during surgery and in the interpretation of imaging studies. Support or Funding Information WV Research Challenge Fund [HEPC.dsr.17.06]