High origin of radial artery: a comparative, anatomical and embryological consideration

Background: Radial artery is one of the terminal branches of the brachial artery arising in the cubital fossa about 1 cm below the bend of the elbow. Diversions of the radial artery from its normal anatomical pattern as regards to its origin or its course constitute the largest group of vascular variations of the upper extremity. Unusual origin of the radial artery may cause failure of transradial approach for percutaneous coronary angiography and difficulty in the reconstructive surgery of the upper limb. Methods: The present study was conducted in the Department of Anatomy at LLRM Medical College on 16 formalin fixed cadavers (12 male and 4 female) of adult age group i.e. 32 upper limbs. Axilla and arm was carefully dissected. Axillary artery and brachial artery were dissected and its branching pattern was observed to note the origin of radial artery. The course of radial artery was noted in each case. Results: Radial artery took origin from the third part of the axillary artery in 3.12%. It arose 2 cm above the lower border of teres major, coursed superficial to median nerve in the arm and continued in the forearm as such. The brachial artery after giving its branches continued as ulnar artery in the forearm. In 96.88%, radial artery arose normally in cubital fossa. Conclusions: High origin and superficial course of the radial artery may be hazardous and vulnerable to injury during venepuncture and surgical procedures. This type of anomaly is due to failure of formation of the communicating branch between superficial brachial artery and axial artery at level of elbow. Awareness about details and topographic anatomy of such variations may help to prevent diagnostic errors, influence surgical tactics and interventional procedures.