Variation in morphology of brachial artery and its branching pattern among black African population: a cadaveric study in western Kenya

Abstract

The brachial artery (BA) is the main arterial supply to the upper limb, BA commences at the inferior border of teres major muscle as a direct continuation of the 3rd part of axillary artery and courses to the arm anterior to triceps and brachialis muscle, it terminates at the neck of the radius, about 1cm by dividing into its two terminal branches, radial and ulnar arteries. There is paucity of data on its anatomical variations and its branching pattern among black African population, thus the purpose of the study was to evaluate anatomical variations of the BA and its branching pattern among black African population. Specifically, the study focused on establishing variation in origin and termination of BA, its branching pattern, length, correlation of variation, and branching pattern between laterality and gender among the black African population. The current study adopted a cross-sectional descriptive study design with purposive sampling as a sampling technique. The study was carried out in three universities in western Kenya due to their functional human anatomy laboratory. The study involved 77 cadavers (38 females and 39 males) with a total of 154 upper limb specimens. It was observed that there were 3.8% variation in origin of BA, the most common variation was superficial origin of BA. In termination of BA 89% terminated at radial neck,7.8% at radial tuberosity,1.9% at proximal arm and 1.3% midarm. 93.4% of the specimen had bifurcation of BA into radial and ulnar arteries, trifurcation was seen in 4.1% of the specimens, High bifurcation of BA was seen in 2.4% of the specimens. Mean length of BA was found to be 26 cm. There was no statistically significant difference variation (p=>0.05) in the origin of BA when compared with the normal origin, however there was statistically significant variation in termination of BA between the right and left upper limbs (p=0.000). The BA is of clinical importance for health care professionals worldwide, it is used clinically for brachial pulse identification, blood pressure monitoring, arteriography, percutaneous arterial catheterization, and arteriovenous fistula (AVF) for dialysis patients, various surgical and radiological procedures thus clinicians should treat each patient as special case to avoid mismanagement, misdiagnosis and improve clinical outcome on procedures involving BA.