The brachial artery bifurcates into the radial and ulnar arteries at the level of the radial neck in the antecubital fossa, with high bifurcation (in the axilla or upper arm) occurring in approximately 15% of individuals. The bifurcation pattern determines antecubital vascular anatomy for surgical planning.
High bifurcation of the brachial artery occurs when the radial artery takes its origin in the axilla or upper arm rather than the antecubital fossa. This variant must be identified before antecubital fossa surgery — a superficially placed radial artery may be mistaken for a vein. In trauma, knowledge of the bifurcation level determines whether forearm ischaemia after elbow injury is from radial or brachial artery injury.
Radial artery origin in the upper arm rather than antecubital fossa occurring in 15% of individuals, relevant in antecubital surgical approaches and arterial cannulation where the vessel may be superficially placed.
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