Anastomosis at the level of the elbow joint connecting the deep, or normal, brachial artery with major arterial variations of the upper limb

Abstract

Major variations of the principal arteries of the upper limb have long received the attention of anatomists. These variations can be summarised as the presence of 2 main arteries traversing the cubital fossa, a deep (or normal) brachial artery in coexistence with a superficial brachial, radial or ulnar artery. Anastomosis between these arterial trunks at elbow level has been reported in 1–6% of cases as an incidental finding in studies on the major arterial variations of the upper limb (Quain, 1844; Müller, 1903; Poynter, 1922; Adachi, 1928; McCormack et al. 1953; Wankoff, 1962; Rodríguez-Baeza et al. 1995). Only a single report (Ljubomudroff, 1927) has dealt specifically with the anastomosis.

The anatomical pattern of the anastomosis has been classified into 2 or 3 types depending on different morphological details. Three types have been described, taking into account its length, calibre and form (Quain, 1844) or the positions of the origin and number of recurrent radial arteries (Ljubomudroff, 1927). Two types have been described on the basis of whether the anastomosis coursed anterior or posterior to the bicipital tendon (McCormack et al. 1953). The aim of this study was to revisit these specific morphological details in a statistically reliable sample in order to catalogue the variations of the anastomosis and to provide an embryological explanation.