Brachial artery, its Branching Pattern and variations with its clinical applications

The present study included both (adult and foetal) cadaveric dissection with clinical studies. The results of the study are based on the routine dissection methods, radiological methods and clinical studies. The branching pattern and the variation of the brachial artery in the present study has contributed to our knowledge regarding the relationship, course and the variation of the branching pattern which is of considerable practical importance in the conduct of reparative surgery in arm, forearm and hand. Their importance lies in the fact that the large artery may occur where the existence of capacious vessels would not ordinarily be expected, because the greater number of aberrant radial and ulnar arteries arise in the proximal half of the arm. The occurrence of accessory major channels through the greater extent of arm is precluded. Consequently, serious secondary haemorrhage might occur in the depth of the wound when the operator has successfully ligated or identified only those vessels which are normally encountered in the area. Careful scrutiny of the anti cubital area, should be made preceeding simple venipuncture, there is a possibility of entering an aberrant ulnar artery. Accidental intra arterial injections may lead to gangrene of fingers, hand and fore arm. This accident is facilitated by the superficial course of the ulnar artery of the high origin and by its consistent relationship to the medial basilic and medial anti-brachial veins. The brachial artery itself may be located superficially in the cubital fossa just medial to the biceps tendon. The superficial position of the arteries make them vulnerable to trauma and also make them more accessible to cannulation if needed. The superficial radial artery and the superficial ulnar artery have been encountered during elevation of the radial forearm flap. The superficial ulnar artery has been suggested on the basis for skin flap. Arteriographic misinterpretation results when the contrast dye is injected distal to the origin of these variant arteries. The existence of the superficial radial artery implies the absence of the normal radial pulse at the wrist level. The recently reported clinical case says that the absence of the ulnar artery was responsible for hand ischaemia after radial artery grafting for coronary bypass. In my extensive studies, I have found many variations regarding the branches of the brachial artery namely profunda brachii, superior ulnar collateral and the presence of superficial brachial artery high origin of radial and ulnar arteries. All these variations pointed out in this study will warn the medical people before they finalised the therapeutic use. In this way my findings about the above said "brachial artery and its branching pattern and variations will be definitely helpful and useful to the clinicians of their respective fields