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Multiple Morphological Radial Artery Variants with Odds of Increased Procedural Complications in Percutaneous Coronary Procedure and Clinical Implications

Olutayo Ariyo

Anatomic variants occurring in the radial artery often occur in singles, but occasionally may have 2 or more co-existing variants. Some of the variants may be etiologic in procedural complications when employed as vessel of choice in percutaneous coronary procedure. We present a brachioradial artery with multiple coexisting anatomic comorbidities that may increase probabilities of procedural complications when employed as vessel of choice in transradial percutaneous coronary procedure occurring in the left limb of a 68-year-old female cadaver. Variants encountered included high origin, the artery arising medially from the third part of the axillary artery (brachioradial), hypoplasty of the artery (diam. < 1.8 mm) plus some moderate tortuosity occurring in the artery just proximal to the cubital fossa, and more significantly, the artery presenting with a stenotic proximal origin.

Artery at origin ran medially and posteriorly placed to the ulnar nerve, then coursed superolateral, impinging on the ulnar nerve. Just proximal to the cubital fossa, artery travelled some length anteriorly placed to the median nerve before adopting the morphology of a normal radial artery in the forearm. Radial artery presenting with multiple coexisting variants will likely increase odds of procedural complications, including procedural elongation or failure in percutaneous coronary procedure. Thus, documenting radial artery variants provides surgeons, specialists, and radiologists with interventional insights.