Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지
DOI QR코드

DOI QR Code

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

  • Yilmaz, Ali (Department Neurosurgery, Adnan Menderes University Faculty of Medicine) ;
  • Ozkul, Ayca (Department Neurology, Adnan Menderes University Faculty of Medicine) ;
  • Shin, Dong Seong (Department Neurosurgery, Soonchunhyang University Bucheon Hospital) ;
  • Im, Soo-Bin (Department Neurosurgery, Soonchunhyang University Bucheon Hospital) ;
  • Yoon, Seok-Mann (Department Neurosurgery, Soonchunhyang University Chonan Hospital) ;
  • Kim, Bum-Tae (Department Neurosurgery, Soonchunhyang University Bucheon Hospital)
  • Received : 2015.07.28
  • Accepted : 2015.10.12
  • Published : 2015.12.28
Download PDF
⟨ Previous Next ⟩

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 $13.41{\pm}2.19mm$, and the RSP was $26.85{\pm}2.47mm$ from the median nerve (MN). The mean length between the medial epicondyle (ME) and the BrAPS as $44.23{\pm}5.47mm$, whereas the distance between the ME and the MN was $42.23{\pm}4.77mm$. The average VAO-ScA angle was $70.94{\pm}6.12^{\circ}$, and the length between the ScA junction (SCJ) and the VAO was $60.30{\pm}8.48mm$. 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.

Keywords

References

  1. Agostoni P, Biondi-Zoccai GG, de Benedictis ML, Rigattieri S, Turri M, Anselmi M, et al. : Radial versus femoral approach for percutaneous coronary diagnostic and interventional procedures; systematic overview and meta-analysis of randomized trials. J Am Coll Cardiol 44 : 349-356, 2004 https://doi.org/10.1016/j.jacc.2004.04.034
  2. Bertrand OF, Belisle P, Joyal D, Costerousse O, Rao SV, Jolly SS, et al. : Comparison of transradial and femoral approaches for percutaneous coronary interventions : a systematic review and hierarchical Bayesian meta-analysis. Am Heart J 163 : 632-648, 2012 https://doi.org/10.1016/j.ahj.2012.01.015
  3. Chakravarthi K : Unusual unilateral multiple muscular variations of back of thigh. Ann Med Health Sci Res 3 (Suppl 1) : S1-S2, 2013
  4. Chakravarthi KK, Ks S, Venumadhav N, Sharma A, Kumar N : Anatomical variations of brachial artery - its morphology, embryogenesis and clinical implications. J Clin Diagn Res 8 : AC17-AC20, 2014
  5. Chodor P, Krupa H, Kurek T, Sokal A, Swierad M, Was T, et al. : RADIal versus femoral approach for percutaneous coronary interventions in patients with Acute Myocardial Infarction (RADIAMI) : a prospective, randomized, single-center clinical trial. Cardiol J 16 : 332-340, 2009
  6. Cooper CJ, El-Shiekh RA, Cohen DJ, Blaesing L, Burket MW, Basu A, et al. : Effect of transradial access on quality of life and cost of cardiac catheterization : a randomized comparison. Am Heart J 138 (3 Pt 1) : 430-436, 1999 https://doi.org/10.1016/S0002-8703(99)70143-2
  7. Franchi E, Marino P, Biondi-Zoccai GG, De Luca G, Vassanelli C, Agostoni P : Transradial versus transfemoral approach for percutaneous coronary procedures. Curr Cardiol Rep 11 : 391-397, 2009 https://doi.org/10.1007/s11886-009-0054-4
  8. Hamon M, Mehta S, Steg PG, Faxon D, Kerkar P, Rupprecht HJ, et al. : Impact of transradial and transfemoral coronary interventions on bleeding and net adverse clinical events in acute coronary syndromes. EuroIntervention 7 : 91-97, 2011 https://doi.org/10.4244/EIJV7I1A16
  9. Jolly SS, Amlani S, Hamon M, Yusuf S, Mehta SR : Radial versus femoral access for coronary angiography or intervention and the impact on major bleeding and ischemic events : a systematic review and meta-analysis of randomized trials. Am Heart J 157 : 132-140, 2009 https://doi.org/10.1016/j.ahj.2008.08.023
  10. Jolly SS, Yusuf S, Cairns J, Niemelä K, Xavier D, Widimsky P, et al. : Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL) : a randomised, parallel group, multicentre trial. Lancet 377 : 1409-1420, 2011 https://doi.org/10.1016/S0140-6736(11)60404-2
  11. Rao SV, Ou FS, Wang TY, Roe MT, Brindis R, Rumsfeld JS, et al. : Trends in the prevalence and outcomes of radial and femoral approaches to percutaneous coronary intervention : a report from the National Cardiovascular Data Registry. JACC Cardiovasc Interv 1 : 379-386, 2008 https://doi.org/10.1016/j.jcin.2008.05.007
  12. Rodriguez-Niedenfuhr M, Vazquez T, Parkin IG, Sanudo JR : Arterial patterns of the human upper limb : update of anatomical variations and embryological development. Eur J Anat 7 Suppl 1 : 21-28, 2003
  13. Romagnoli E, Biondi-Zoccai G, Sciahbasi A, Politi L, Rigattieri S, Pendenza G, et al. : Radial versus femoral randomized investigation in ST-segment elevation acute coronary syndrome : the RIFLE-STEACS (Radial Versus Femoral Randomized Investigation in ST-Elevation Acute Coronary Syndrome) study. J Am Coll Cardiol 60 : 2481-2489, 2012 https://doi.org/10.1016/j.jacc.2012.06.017
  14. Uglietta JP, Kadir S : Arteriographic study of variant arterial anatomy of the upper extremities. Cardiovasc Intervent Radiol 12 : 145-148, 1989 https://doi.org/10.1007/BF02577379
  15. Valgimigli M, Saia F, Guastaroba P, Menozzi A, Magnavacchi P, Santarelli A, et al. : Transradial versus transfemoral intervention for acute myocardial infarction : a propensity score-adjusted and -matched analysis from the REAL (REgistro regionale AngiopLastiche dell'Emilia-Romagna) multicenter registry. JACC Cardiovasc Interv 5 : 23-35, 2012 https://doi.org/10.1016/j.jcin.2011.08.018
  16. Valsecchi O, Vassileva A, Musumeci G, Rossini R, Tespili M, Guagliumi G, et al. : Failure of transradial approach during coronary interventions : anatomic considerations. Catheter Cardiovasc Interv 67 : 870-878, 2006 https://doi.org/10.1002/ccd.20732
  17. Yang HJ, Gil YC, Jung WS, Lee HY : Variations of the superficial brachial artery in Korean cadavers. J Korean Med Sci 23 : 884-887, 2008 https://doi.org/10.3346/jkms.2008.23.5.884
  18. Zhan D, Zhao Y, Sun J, Ling EA, Yip GW : High origin of radial arteries : a report of two rare cases. ScientificWorldJournal 10 : 1999-2002, 2010 https://doi.org/10.1100/tsw.2010.187

Cited by

  1. Invention of the Guide Catheter Irrigation Monitoring Device for Neuroendovascular Therapy vol.60, pp.4, 2017, https://doi.org/10.3340/jkns.2017.0101.001
  2. Implications of Mechanical Endovascular Thrombectomy for Acute Basilar and Posterior Cerebral Artery Occlusion vol.20, pp.3, 2018, https://doi.org/10.7461/jcen.2018.20.3.168