AN OBSERVATIONAL CROSS-SECTIONAL CADAVERIC STUDY OF ACCESSORY BRACHIAL ARTERIES ASSOCIATED WITH PERSISTENT MEDIAN ARTERY AND INCOMPLETE SUPERFICIAL PALMAR ARCH

Background: Variations in the upper limb arteries are clinically significant due to their implications in surgical, radiological, and interventional procedures. The accessory brachial artery (ABA) is a rare vascular anomaly resulting from persistence of embryonic arterial channels. The aim is to identify and document ABAs and associate arterial variations in the forearm and hand and discuss their embryological and clinical significance.
Materials and Methods: A descriptive observational cross sectional cadaveric study was done on 30 upper limb specimens from 15 embalmed cadavers. Standard dissection techniques were employed to trace the origin, course, branching pattern, and termination of the arteries. Observations during dissection were documented and compared with existing literature.
Result: ABA was observed in 2 specimens (6.66%), each occurring unilaterally. In one case (3.33%), it originated from the axillary artery in the left upper limb, while in another (3.33%), it originated from the brachial artery in the right upper limb. In both cases, the artery continued as the radial artery, with variations in its relation to the median nerve. Associated findings included persistent median artery and alterations in the branching pattern of the brachial artery. A complete superficial palmar arch was observed in 93.33% of specimens, while incomplete arches (6.67%) corresponded to cases with vascular variations. According to Coleman and Anson classification, these were identified as Type B and Type C arches.
Conclusion: The presence of (ABA), persistent median artery (PMA), and incomplete palmar arches highlights the complexity of upper limb vascular anatomy. Awareness of these variations is essential for clinicians to prevent iatrogenic injury and ensure safe surgical and interventional procedures. Preoperative vascular assessment is recommended in suspected cases.