Anatomical Variations of Upper Limb Arteries
Summary
Anatomical variations of the arteries supplying the upper limb are frequent and clinically significant. Variants include high origin of the radial artery (brachioradial artery), superficial courses of brachial or ulnar arteries, and early bifurcation of the brachial artery above the cubital fossa. Embryologically, these arise from persistence or regression of transient vascular channels during limb development. Reported prevalence of radial artery high origin ranges from below 1 % to over 10 % across populations, while superficial vessels may be encountered in up to 20 % of dissections. Such deviations can modify perfusion patterns of the forearm and hand, affect collateral circulation and increase the risk of iatrogenic injury during catheterisation, flap harvest or reconstructive surgery. Modern imaging techniques, standardised classification systems and consistent terminology are essential for preoperative planning, reducing surgical complications and improving outcomes in microsurgery, vascular access and orthopaedic interventions. Global studies emphasise regional differences and underscore the need for heightened anatomical awareness.
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Anatomical Variations of Upper Limb Arteries publication trend
The graph below shows the total number of articles in anatomical variations of upper limb arteries across all publications each year (not limited to Nature Index journals).
Technical terms
Brachioradial artery: A variant radial artery arising proximally from the brachial or axillary artery, rather than at the cubital fossa.
Superficial brachial artery: An atypical vessel that courses superficially to forearm muscles and may replace or accompany the conventional brachial artery.
High bifurcation: Early division of the brachial artery into its terminal branches at a point more proximal than normal.
Anastomosis: A physiological connection between two arteries allowing collateral blood flow.
High origin: The proximal emergence of an arterial branch at an atypical location above its standard anatomical level.
References
- Pedicled Radial Forearm “Free” Flap for Intraoral Reconstruction Based on an Unexpectedly High Origin of the Radial Artery—Case Report. Clinics and Practice (2024).
- An Unusual High Bifurcation of the Brachial Artery: A Cadaveric Case Report. Cureus (2024).
- Morphological variations of the brachial artery and their clinical significance: a systematic review. Surgical and Radiologic Anatomy (2023).
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