Major variations of the principal arteries of the upper limb
have long received the attention of anatomists. These
variations can be summarised as the presence of 2 main
arteries traversing the cubital fossa, a deep (or normal)
brachial artery in coexistence with a superficial brachial,
radial or ulnar artery. Anastomosis between these arterial
trunks at elbow level has been reported in 1–6% of cases as
an incidental finding in studies on the major arterial
variations of the upper limb (Quain, 1844; Müller, 1903;
Poynter, 1922; Adachi, 1928; McCormack et al. 1953;
Wankoff, 1962; Rodríguez-Baeza et al. 1995). Only a single
report (Ljubomudroff, 1927) has dealt specifically with the
anastomosis.
The anatomical pattern of the anastomosis has been
classified into 2 or 3 types depending on different morphological
details. Three types have been described, taking
into account its length, calibre and form (Quain, 1844) or
the positions of the origin and number of recurrent radial
arteries (Ljubomudroff, 1927). Two types have been described on
the basis of whether the anastomosis coursed
anterior or posterior to the bicipital tendon (McCormack et
al. 1953). The aim of this study was to revisit these specific
morphological details in a statistically reliable sample in
order to catalogue the variations of the anastomosis and to
provide an embryological explanation.