High originating radial artery: anatomical study through the use of ultrasound

Typically, the radial artery arises as a branch from the brachial artery at the level of the neck of the radius in the distal antecubital fossa. Anatomical variations in the radial artery are relatively common. Published literature demonstrates a wide variability in the prevalence of high originating radial artery (0.5-14.27%). The literature also shows inconsistent and vague nomenclature when describing the arterial system in cases of high originating radial artery. This study aims to investigate the incidence of a high originating radial artery in vivo through the use of ultrasound. It goes on to propose a classification system utilising precise nomenclature to help in discriminating between the various patterns. METHODS. Fifty-four upper limbs from 27 individuals were investigated using GE LOGIQ e and SonoSite MicroMaxx ultrasound machines with 12L-RS & A L38e 10-5MHz transducer respectively. The radial artery was initially identified and followed proximally to its origin and then distally to the wrist noting its course and relationships to other anatomical structures. SUMMARY. High originating radial arteries were found unilaterally in 4 individuals (4/54, 7.4%). CONCLUSION. Variations in the anatomical course and relationships of the radial artery are pertinent to surgeons, radiologists and anatomists. The presence of a high originating radial artery has both clinical and surgically significance in procedures, such as arterial grafting and cardiac catheterization. Due to its superficial course, it is more vulnerable to injury due to trauma or during cannulation and drug administration. Bedside ultrasound techniques can not only be of benefit in identifying variations prior to such procedures but also for future anatomical studies.