Literature Reviews
doi: 10.25005/2074-0581-2017-19-1-113-119
ANATOMICAL VARIATIONS IN UPPER LIMB ARTERIES

R.Е. Каlinin1, I.А. Suchkov1, N.D. Мjavanadze1, R.М. Мustafaeva1

1Federal State Budget Educational Institution of Higher Professional Education «Ryazan State Medical University named after academician I.P. Pavlov» of the Ministry of Health of the Russian Federation, Ryazan, Russian Federation

Upper extremity arterial disorders are less common than lower extremity disorders. Occlusion and critical stenoses of the arteries lead to the development of ischemia, during which anatomical features of the upper limbs structure play an important role. A large number of anastomoses and a well developed collateral circulation often lead to compensation of blood circulation. During the conducting an open treatment the vascular surgeons meet a non-standard anatomy that presents technical obstacles to the performance. The current article reviews the anatomical variations in upper limbs and formed among them anastomoses which any surgeon may encounter. Having analysed the experiences of colleagues led to the conclusion that the non-classical origin and location of upper limb arteries are a frequent phenomenon that can significantly affect to the medical strategy and change the condition of ischemia of the upper extremities. These data must be taken into consideration in angiographic studies, selection of access during surgical interventions and medical manipulations. Therefore, it is important to conduct a careful examination of each patient to the surgical treatment in order to identify individual characteristics and avoid mistakes.

Keywords: Atherosclerosis, arteries of the upper limbs, variant anatomy, anastomoses, collateral circulation.

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References
  1. Kalinin RE, Abrosimov VN, Suchkov IA, Burshinov OA, Pshennikov AS, Zhukova LA, i dr. Ishemicheskie bolezni v praktike semeynogo vracha [Ischemic diseases in the practice of family doctor]. Moscow, RF: GEOTARMedia; 2016. 208 p.
  2. Kalinin RE, Suchkov IA, Zherebyat’eva SR, Pshennikov AS. Operatsii na sosudakh [Operations on vessels]: Uchebnoe posobie. Moscow, RF: Izdatelskiy Dom «GEOTAR-MED»; 2015. 119 p.
  3. Suchkov IA, Pshennikov AS, Gerasimov AA, Agapov AB, Kamaev AA. Profilaktika restenoza v rekonstruktivnoy khirurgii magistral’nykh arteriy [Prevention of restenosis in the reconstructive surgery of arteries]. Nauka molodykh – Eruditio Juvenium. 2013;2:12-9.
  4. Pokrovskiy AV. (red.) Klinicheskaya angiologiya [Clinical angiology]: Rukovodstvo. V 2 tomakh. T1. Moscow, RF: OAO Izdatel’stvo «Meditsina»; 2004. 808 p.
  5. Gossage JA, Ali T, Chambers J, Burnand KG. Peripheral arterial embolism: prevalence, outcome, and the role of echocardiography in management. Vasc Endovasc Surg. 2006;40(4):280-6.
  6. Prives MG, Lysenkov VI, Bushkevich VI. Anatomiya cheloveka [Human anatomy]. Uchebnik dlya meditsinskikh vuzov. Saint Petersburg, RF: Izd-vo SPbMAPO; 2010. 472 p.
  7. Nikolaev AV. Topograficheskaya anatomiya i operativnaya khirurgiya [Topographical anatomy and operative surgery]: Uchebnik. 2 izdanie. T.1. Moskow, RF: “GEOTAR”; 2009. 384 p.
  8. Gayvoronskiy IV. Kollateral’noe krovoobrashchenie: proshloe, nastoyashchee, budushchee [Collateral circulation: past, present, future]. Meditsina. XXI Vek. 2006;3:32-8.
  9. Sultanov DD, Karimov TN. Revaskulyarizatsiya pri distal’nykh porazheniyakh arteriy verkhnikh konechnostey [Revascularization in distal lesions of upper extremities arteries]. Avicenna Bulletin (Vestnik Avitsenny). 2012; 2(51):167-73.
  10. Karimov TN, Sultanov DD, Hodzhaev FM, Kuzieva MD. Narushenie gemodinamiki i ishemiya pri distal’nykh porazheniyakh arteriy verkhnikh konechnostey [Violation of hemodynamics and ischemia in distal lesions of arteries of the upper extremities]. Vestnik Tadzhikskogo natsional’nogo universiteta. Seriya estestvennykh nauk [Bulletin of the Tajik National University. A series of natural sciences]. 2015;1-1(156):209-13.
  11. Karimov TN, Sultanov DD, Hodzhaev FM. Pryamye i nepryamye metody revaskulyarizatsii pri distal’nykh porazheniyakh arteriy verkhnikh konechnostey [Direct and indirect methods of revascularization in distal lesions of upper extremities arteries]. Vestnik Tadzhikskogo natsional’nogo universiteta. Seriya estestvennykh nauk [Bulletin of the Tajik National University. A series of natural sciences]. 2014;1-2(130):231-8.
  12. Arutyunov AI. Ognestrel’nye povrezhdeniya krovenosnykh sosudov [Gunshot damage to blood vessels]. Kiev, Ukraine; 2009. 208 p.
  13. Kalmykov EL, Kalinin RE, Magamet VP, Suchkov IA, Mzhavanadze ND, Sadriev OK. Sindrom sredney aorty [Syndrome, middle aortic]. Vestnik khirurgii im. I.I. Grekova. 2016;175(6):104-108.
  14. Bidarkotimath S, Avadhani R, Kumar A. Primary pattern of arteries of upper limb with relevance to their variations. Int J Morphol. 2011;29(4):1422-8.
  15. Bidarkotimath S, Avadhani R, Kumar A. An anatomical study of primary pattern of arteries of upper limb with relevance to their variations. NUJHS. 2012;2(1):8-14.
  16. Arey LB. Developmental anatomy. 6th ed. Philadelphia: WB. Saunders; 1957. p. 375-7.
  17. Natsis К, Papadopoulou AL, Papathanasiou E, Noussios G, Paraskevas G. Study of two cases of high origin radial artery in humans. Eur J Anat. 2009;13(2):97-103.
  18. Mac Cormack LJ, Cauldevell EW, Anson BJ. Brachial and antebrachial arterial patterns a study of 750 extremities. Surg Gynaecol Obstet. 1953;96:43-54.
  19. Rossi Junior WC, Esteves A, Simoes JS, Fernandes GJM. Bilateral high division of brachial artery in one human male cadaver; case report. J Morphol Sci. 2011;28(3):204-7.
  20. Rohilla A, Parmar P, Singh K, Rohilla J. Unilateral high division of brachial artery and its clinical significance. Int J Res Med Sci. 2016;4:5513-5.
  21. Gadzhieva FG. Zasimovich TV, Pavlyukevich EV, Gil IV. Variantnaya anatomiya plechevoy arterii i eyo vetvey [Variant anatomy of the brachial artery and its branches]. V: «Sbornik statey nauchnoy konferetscii, posvyashchennoy pamyati dotsenta Z.A. Pashenko»; 2011 May 20; Grodno, Belarus. Grodno, Belarus: GrGMU; 2011. p.10.
  22. Gadzhieva FG, Okolokulak ES. Izmenenie formy magistral’nykh arteriy predplech’ya i ikh klinicheskaya znachimost’ [Changing the shape of the main arteries of the forearm and their clinical significance]. V: «Sbornik trudov nauchno-prakticheskoy konferentsii s mezhdunarodnym uchastiem, posvyashchennoy 115-letiyu so dnya rozhdeniya akademika Davida Moiseevicha Goluba».V 2 tomah. T.1. Minsk, Belarus: BGMU; 2016. p. 92-4.
  23. Semyonov SN, Alekseeva NT, Lopatina LA, Anokhina ZhA, Terezanov OYu. K voprosu o variantnoy anatomi nekotorykh krovenosnykh sosudov [To a question on alternative anatomy of some blood vessels]. Vestnik eksperimental’noy i klinicheskoy khirurgii. 2009;2(1):68-9.
  24. Deepa TK, Martin KJ. An anatomical study of variations in termination of brachial artery, with its embryological basis and clinical significance. Int J Med Res Health Sci. 2016;5(3):85-9.
  25. Venkata RV, Raghu J, Simmi S. High origin of ulnar artery – Development and Surgical Significance. Chang Gung Med J. 2011;34(6):39-42.
  26. Shubha R, Sudarshan Babu KG, Mekala D, Jeyanthi K, Lalitha C. An anatomical study of variations in termination of brachial artery: embryological basis and clinical implication. J Dent. Med Sci. 2013;9(1):68-75.
  27. Vandana R, Suresh NM, Lakshmi PR, Veena P. Variation in course and branching pattern of brachial artery. Anatomica Karnataka. 2012;6(3):42-8.
  28. Patnaik VVG, Kalse G, Sigla RK. Trifurcation of brachial artery – a case report. J Anat Soc India. 2001;50(2):163-5.
  29. Srijit D, Shashi S, Shipra P. Double profunda brachii and abnormal branching pattern of brachial artery. TMJ. 2005;55(2):159-61.
  30. Jacomo AL, Martinez CAR, Saleh SO, Andrade M, Akamatsu FE. A rare pattern of brachial artery variation – case report. Int J Morphol. 2014;32(2):542-5.
  31. Yang HJ, Gil YC, Jung WS, Lee HY. Variations of the superficial branchial artery in Korean Cadavers. J Korean Med Sci. 2008;23(5):884-7.
  32. Chakravarthi KK, Siddaraju KS, Venumadhav N, Sharma A, Manipal NK. Anatomical Variations of Brachial Artery - Its Morphology, Embryogenesis and Clinical Implications. J Clinic Diagn Res. 2014;8(12):17-20.
  33. Teli Ch, Nilesh NK, Paarthipan N. High division and variation in brachial artery branching pattern. J Dent Med Sci. 2013;3(6):68-70.
  34. Gujar SM, Oza SG, Shekhawat PJ, Vikani SK, Prajapati SB. A study on division of brachial artery and its clinical correlations. Int J Anat Res. 2014;2(1):208-12.
  35. Konarik M. Superficial brachioradial artery: a case report and its embryological background. Folia Morphol. 2009;68:174-8.
  36. Gupta Ch, Palimar V, Murlimanju BV, Shetti VR. A morphological study of variations in the origin and course of radial artery. Res J Pharmaceutical, Biological and Chemical Sci. 2012;3(2):333.
  37. Shewale SN, Sukre SB, Diwan CV. Bifurcation of brachial artery at it’s commencement. Biomedical Res. 2012;23(3):453-6.
  38. Rodriguez-Niedenfuhr M, Vazquez T, Nearn L, Ferreira B, ParkinI, Sannudo JR. Variations of the arterial pattern in the upper limb revisited: a morphological and statistical study, with a review of the literature. J Anat. 2001;199:547-66.

Authors' information:

Kalinin Roman Evgenyevich,
Doctor of Medical Sciences, Full Professor, Head at the Department of Cardiovascular Surgery, Vascular and Interventional Radiology, Operative Surgery and Topographic Anatomy at Ryazan State Medical University named after academician I.P. Pavlov

Suchkov Igor Aleksandrovich,
Doctor of Medical Sciences, Associate Professor, Professor at the Department of Cardiovascular Surgery, Vascular and Interventional Radiology, Operative Surgery and Topographic Anatomy at Ryazan State Medical University named after academician I.P. Pavlov

Mjavanadze Nina Djansugovna,
Candidate of Medical Sciences, Assistant in the Department of Cardiovascular Surgery, Vascular and Interventional Radiology, Operative Surgery and Topographic Anatomy at Ryazan State Medical University named after academician I.P. Pavlov

Mustafaeva Rugiya Mahir kizi,
clinical resident doctor at the Department of Cardiovascular Surgery, Vascular and Interventional Radiology, Operative Surgery and Topographic Anatomy at Ryazan State Medical University named after academician I.P. Pavlov

Conflicts of interest: No conflict

Address for correspondence:

Suchkov Igor Aleksandrovich

Doctor of Medical Sciences, Associate Professor, Professor at the Department of Cardiovascular Surgery, Vascular and Interventional Radiology, Operative Surgery and Topographic Anatomy at Ryazan State Medical University named after academician I.P. Pavlov

390026, Russian Federation, Ryazan, Vysokovoltnaya Street, 9

Tel: (+7) 903 8362417

E-mail: suchkov_med@mail.ru

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