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2012
Pulei A, Inyimili M, Ogeng’o J, Kitunguu P, ONGETI K, Obimbo M. ". Surgical significance of brachial arterial variants in a Kenyan population." Annals of African Surgery. 2012;9. Abstract

Surgical significance of brachial arterial variants in a Kenyan population
A Pulei, M Obimbo, K Ongeti, P Kitunguu, M Inyimili, J Ogeng’o

Abstract

Background: Knowledge of the variant anatomy of the brachial artery is important in radial arterial grafts for coronary bypass, percutaneous trans-radial approach to coronary angiography, angioplasty and flap surgery. These variations show ethnic differences but data from black populations are scarce. This study therefore describes the course in relation with median nerve, level and pattern of termination of brachial artery in a black Kenyan population.
Methods: This was a cadaveric dissection study of 162 upper limbs at the Department of Human Anatomy University of Nairobi, Kenya. The brachial artery was exposed entirely from the lower border of teres major to its point of termination. The course in relation to the median nerve and the level of termination were recorded. The results were analyzed using SPSS version 17.0 for Windows.
Results: 72.2% of the brachial arteries followed the classical pattern described in Gray’s Anatomy. Superfi cial brachioradial and superficial brachial arteries were present in 12.3% and 6.1% of the cases respectively. Brachial artery terminated at the radial neck in 79% of the cases, radial tuberosity (8.6%), and proximal arm (11.1%), mid arm (1.2%). Pattern of termination was either a bifurcation into the radial and ulnar arteries (90.1%) or trifurcation into radial, ulnar and common interosseous arteries (9.3%). We also report a case of trifurcation of the brachial artery into the profunda brachii, radial and ulnar arteries (0.6%).
Conclusion: Variations of the brachial artery in its relationship with the median nerve, level and pattern of termination are common. These may complicate arm surgical exposures, fl ap and vascular surgery. Pre-operative angiographic evaluation is recommended.

Keywords: brachial artery, bifurcation, trifurcation, superficial brachioradial artery

Pulei JO’oA, Martin Inyimili, Ogeng’o J, Ongeti K. "SURGICAL ANATOMY OF THE PROFUNDA BRACHII ARTERY." Anatomy Journal of Africa. 2012;1(1):20-23. Abstract

Correspondence: Dr. Anne Naipanoi Pulei, Department of Human Anatomy, University of Nairobi. P.O. Box 30197 00100 Nairobi, Kenya. Email: anmunkush@yahoo.com
SUMMARY
Variations in the origin and termination of the profunda brachii artery (PBA) are rarely described in literature. Knowledge of this unusual anatomy is important during brachial artery catheterization and harvesting of lateral arm flaps. One hundred and forty four arms from 72 cadavers of black Kenyans were dissected and examined for the origin and termination of PBA at the Department of Human Anatomy, University of Nairobi, Kenya. The patterns of origin and termination of the PBA were observed and recorded. The PBA was present in all the cases. It arose from the brachial, axillary and a common stem with the superior ulnar collateral arteries in 96.9%, 1.4% and 1.7% of the cases respectively. It displayed duplication and early branching in 11.1% and 16.7% of the cases respectively. The high incidence of duplication and early branching makes it vulnerable to inadvertent injury during fractures of the humerus, brachial artery catheterization and may complicate lateral arm flaps. Preoperative angiographic evaluation is therefore recommended.
Key words: Profunda brachii arteries, variations.

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