Morphological and Topographical Features of the Radial Recurrent Artery and Its Possible Clinical Significance

Latif Sağlam; Özcan Gayretli; Osman Coşkun; İlke Ali Gürses; Buse Naz Çandır; Ayşin Kale; Adnan Öztürk

doi:10.58600/eurjther1908

Authors

Latif Sağlam Department of Anatomy, Istanbul Faculty of Medicine, Istanbul University; Istanbul, Turkey https://orcid.org/0000-0001-6796-7484
Özcan Gayretli Department of Anatomy, Istanbul Faculty of Medicine, Istanbul University; Istanbul, Turkey https://orcid.org/0000-0001-7958-3170
Osman Coşkun Department of Anatomy, Istanbul Faculty of Medicine, Istanbul University; Istanbul, Turkey https://orcid.org/0000-0002-0337-4927
İlke Ali Gürses Department of Anatomy, School of Medicine, Koç University, Istanbul, Turkey https://orcid.org/0000-0001-9188-4662
Buse Naz Çandır Department of Anatomy, Faculty of Medicine, Istanbul Yeni Yüzyıl University, Istanbul, Turkey https://orcid.org/0000-0003-3138-8098
Ayşin Kale Department of Anatomy, Istanbul Faculty of Medicine, Istanbul University; Istanbul, Turkey https://orcid.org/0000-0002-2305-420X
Adnan Öztürk Department of Anatomy, Faculty of Medicine, Istanbul Health and Technology University, İstanbul, Turkey https://orcid.org/0000-0002-5819-0543

DOI:

https://doi.org/10.58600/eurjther1908

Keywords:

Radial recurrent artery, morphology, morphometry, anatomy, clinical significance

Abstract

Objective: The anatomy of the radial recurrent artery (RRA) is very important for interventional procedures. The aim of this study was to investigate the morphological and topographic anatomy of the RRA.

Methods: The study was conducted on 20 human cadavers (14 male and 6 female, 40 upper limbs). The RRA was classified into 4 groups as follows according to the observed origin: RRA originated from the radial artery (RA) (Type A), the root of the RA (Type B), the brachial artery (BA) (Type C), and the ulnar artery (UA). The relative positioning of the RRA in relation to the biceps brachii muscle tendon (TBB), in terms of the antero-posterior direction was determined. The vertical distance of the origin point of the RRA to the intercondylar line and the diameters of this artery were determined. Morphometric evaluation was performed with a digital caliper. The obtained data were analyzed using SPSS version 21.00 software.

Results: The artery most commonly originated from the RA (Type A 47.5%, 19 extremities). This was followed by RA root (Type B 32.5%, 13 extremities), BA (Type C 17.5%, 7 extremities), and UA (Type D 2.5%, 1 extremity). The RRAs coursed anteriorly to the TBB in 38 extremities (95%) and passed behind the tendon in 2 extremities (5%). The vertical distance of the origin point of the RRA to the intercondylar line was meanly 32.20 ±6.86 mm. The diameter of the artery at its origin point was meanly 2.57 ± 0.58 mm and just after its first branch was meanly 2.05 ± 0.48 mm. Our study documents a rare morphological variation of the RRA originating from the UA (Type D).

Conclusion: While many of our findings align with previous studies, this research presents novel anatomical findings and elucidates the superficial course and topographical positioning of the RRA to estimate its origin point.

Metrics

Metrics Loading ...

References

Vazquez T, Sañudo J, Carretero J, Parkin I, Rodríguez-Niedenführ M (2013) Variations of the radial recurrent artery of clinical interest. Surg Radiol Anat 35(8):689-694. https://doi.org/10.1007/s00276-013-1094-4

Wysiadecki G, Polguj M, Haładaj R, Topol M (2017) Low origin of the radial artery: a case study including a review of literature and proposal of an embryological explanation. Anat Sci Int 92(2):293-298. https://doi.org/10.1007/s12565-016-0371-9

Blondeel PN, Morris SF, Hallock GG, Neligan PC (2013) Perforator flaps: anatomy, technique, & clinical applications. 2nd edn. CRC Press, Missouri.

Devale MM, Munot RP, Bhansali CA, Bhaban ND (2016) Awkward defects around the elbow: The radial recurrent artery flap revisited. Indian J Plast Surg 49(3):357-361. https://doi.org/10.4103/0970-0358.197235

Hamahata A, Nakazawa H, Takeuchi M, Sakurai H (2012) Usefulness of radial recurrent artery in transplant of radial forearm flap: an anatomical and clinical study. J Reconstr Microsurg 28(3):195-198. https://doi.org/10.1055/s-0031-1301071

Conklin LD, Ferguson ER, Reardon MJ (2001) The technical aspects of radial artery harvesting. Tex Heart Inst J 28(2):129-131.

Kırali K, Yakut N, Güler M, Ömeroğlu S, Mansuroğlu D, Akıncı E (1999) Koroner arter bypass cerrahisinde radial arter: Anatomik komşulukları ve çıkarma tekniği. Türk Göğüs Kalp Damar Cer Derg 7:358-361.

Wang B, Liang KW, Chen CH, Wang CK (2022) Transcatheter Arterial Embolization for Alleviating Chronic Musculoskeletal Pain and Improving Physical Function: A Narrative Review. Diagnostics (Basel) 13(1):134. https://doi.org/10.3390/diagnostics13010134

Aly M, Fashina C, Hagiga A, Hafez A, Di Mascio L (2023) Transcatheter arterial embolisation for the relief of shoulder and elbow chronic joint pain refractory to conventional treatment: Systematic review. J Med Imaging Radiat Oncol 67(7):756-768. https://doi.org/10.1111/1754-9485.13590

Zeltser DW, Strauch RJ (2016) Vascular anatomy relevant to distal biceps tendon repair. J Shoulder Elbow Surg 25(2):283-288. https://doi.org/10.1016/j.jse.2015.08.042

Glin M, Zielinska N, Ruzik K, Karauda P, Konschake M, Olewnik Ł (2023) Morphological variations of the brachial artery and their clinical significance: a systematic review. Surg Radiol Anat 45(9):1125-1134. https://doi.org/10.1007/s00276-023-03198-5

Bhatt V, Green J, Grew N (2009) Dealing with aberrant vessels in radial forearm flaps–report of a case and review of literature. J Craniomaxillofac Surg 37(2):87-90. https://doi.org/10.1016/j.jcms.2008.11.005

Gaudino M, Crea F, Cammertoni F, Mazza A, Toesca A, Massetti M (2014) Technical issues in the use of the radial artery as a coronary artery bypass conduit. Ann Thorac Surg 98(6):2247-54. https://doi.org/10.1016/j.athoracsur.2014.07.039

Zheng Y, Shao L, Mao J-y (2014) Bilaterally symmetrical congenital absence of radial artery: a case report. BMC Surg 21;14:15. https://doi.org/10.1186/1471-2482-14-15

Gupta C, Ray B, Dsouza AS, Nair N, Pai S, Manju M (2012) A morphological study of variations in the branching pattern and termination of the radial artery. Singapore Med J 53(3):208-211.

Nasr A (2012) The radial artery and its variations: anatomical study and clinical implications. Folia Morphol (Warsz) 71(4):252-262.

Adachi B (1928) Das Arterien System der Japaner. Vol 1. Keiserlich-Japanischen Universitat, Kyoto.

Haładaj R, Wysiadecki G, Dudkiewicz Z, Polguj M, Topol M (2018) The High Origin of the Radial Artery (Brachioradial Artery): Its Anatomical Variations, Clinical Significance, and Contribution to the Blood Supply of the Hand. Biomed Res Int 2018:1520929. https://doi.org/10.1155/2018/1520929

Campero A, Villalonga JF, Elizalde RL, Ajler P (2018) The nuchal lines as anatomic landmarks to dissect the muscles in the far lateral approach. World Neurosurg 113:188-194. https://doi.org/10.1016/j.wneu.2018.02.090

Janis JE, Hatef DA, Ducic I, Reece EM, Hamawy AH, Becker S, Guyuron B (2010) The anatomy of the greater occipital nerve: Part II. Compression point topography. Plast Reconstr Surg 126(5):1563-1572. https://doi.org/10.1097/PRS.0b013e3181ef7f0c

Patnaik V, Kalsey G, Singla RK (2001) Trifurcation of brachial artery-A case report. J Anat Soc India 50(2):163-165.

Luther E, Burks J, Abecassis IJ, Nada A, Heath R, Berry K, McCarthy DJ, Saini V, Silva M, Huang E, Strickland A, Yavagal DR, Peterson EC, Levitt MR, Starke RM (2021) Navigating radial artery loops in neurointerventions. J Neurointerv Surg 13(11):1027-1031. https://doi.org/10.1136/neurintsurg-2020-016856