J Korean Neurosurg Soc.  2015 Dec;58(6):499-503. 10.3340/jkns.2015.58.6.499.

Morphological Assessment of Cadaveric Radial, Brachial and Subclavian Arteries: A Neurointerventional Approach

• Yilmaz A
• Ozkul A
• Shin DS
• Im SB
• Yoon SM
• Kim BT

• KMID: 2151149
• DOI: http://doi.org/10.3340/jkns.2015.58.6.499

Abstract

OBJECTIVE
The transradial catheterization (TRC) is becoming widespread, primarily for neurointerventions. Therefore, the evaluation of radial artery puncture in clinical practice and a better understanding of the anatomy are important to improve the safety of neuroendovascular surgery.
METHODS
Ten formalin-fixed adult Korean cadavers were dissected to expose radial artery (RA), brachial artery (BrA) and subclvian artery (ScA), bilaterally. Vessel lengths and diameters were meaured using a caliper and distance between the specific point of vessels and the anatomical landmarks including the radial styloid process, the medial epicondyle of the humerus, the sternoclavicular joint, and the vertebral artery orifice were also measured.
RESULTS
The average length between the radial (RAPS) and the BrA puncture sites (BrAPS) and between the vertebral artery orifice (VAO) and the BrA bifurcation (BrAB) did not differ between sides (p>0.05). The average length between the radial styloid process (RSP) and the RAPS was 13.41+/-2.19 mm, and the RSP was 26.85+/-2.47 mm from the median nerve (MN). The mean length between the medial epicondyle (ME) and the BrAPS as 44.23+/-5.47 mm, whereas the distance between the ME and the MN was 42.23+/-4.77 mm. The average VAO-ScA angle was 70.94+/-6.12degrees, and the length between the ScA junction (SCJ) and the VAO was 60.30+/-8.48 mm.
CONCLUSION
This study provides basic anatomical information about the radial artery and the brachial route and can help improving new techniques, selection of size and shape of catheters for TRC. This can help neurointerventionists who adopt a transradial neuroendovascular approach and offers comprehensive and safe care to their patients.

Keyword

Transradial; Neuroendovascular approach; Radial artery anatomy

MeSH Terms

Adult
Arteries
Brachial Artery
Cadaver*
Catheterization
Catheters
Humans
Humerus
Median Nerve
Punctures
Radial Artery
Sternoclavicular Joint
Subclavian Artery*
Vertebral Artery

Figure

• 

  Fig. 1 Distances from RSP to RAPS and MN at the wrist level (A) and from ME to MN and BrAPS at the elbow (B) were measured. The same measurements, along with the VAO-ScA angle, were made between the SCJ and the VAO (C and D). RSP : radial styloid process, RAPS : radial artery puncture site, ME : medial epicondyle, MN (*) : median nerve, BrAPS (blue pin) : brachial artery puncture site, Lt CCA : left common carotid artery, SCJ : sternoclavicular joint, ScA : subclavian artery, VAO : vertebral artery orifice.

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