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Anatomical pitfalls of radial artery catheterization: variations in branching pattern

Publication at Faculty of Medicine in Pilsen, Third Faculty of Medicine |
2012

Abstract

This article follows that on the normal anatomy and embryology of arteries of the upper limb and, in particular, deals with the variations in the course and branching pattern in terms of use in catheterization via the radial artery approach. This concerns a group of nearly 23% of cases where other than the basic textbook pattern can be encountered.

Although this figure is rather high, in the vast majority of cases, catheterization and the planned procedure in the coronary vascular bed can be performed and successfully completed. Variations in the arteries of the upper limb can be divided into changes in the direct course of the arteries and developmental anomalies in the arrangement of the main trunks.

The latter include various differently developed trunks in the course of the brachial, ulnar, radial as well as other arteries, of which the brachioradial artery is most frequent (it has a higher susceptibility to spasm or may more often be hypoplastic). Rarely, trunks may even be absent.

Thus, the method of intervention in the coronary vascular bed via the radial artery is not only an alternative to the femoral approach, but even a safer route and the method of first choice for the future.