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At least 19 recordsLinked to original sources
PubMed1994

[Non-iatrogenic trauma of the brachial artery].

Brachial artery trauma are treated quite frequently in the emergency units. Between January 1987 and December 1990 we studied prospectively 50 patients with brachial artery trauma at the Hospital das Clinicas, of University of Sao Paulo. The patients mean age ranged from 2 to 64 years. Males were predominant with 46 patients. Most of them were white (66%). Penetrating injuries were the most frequent. Most of these injuries were caused by gunshot wounds or stabing. Absence of distal palpable pulses was the predominant finding among the clinical features (94%). 74% of the patients do not present important ischemia. The right side was more affected (34 patients). 14 patients had concomitant nerve injury. 35 patients (70%) were submitted to arterial reconstruction with saphenous vein. 12 patients (24%) had end-to-end vascular anastomoses. 3 patients (6%) were submitted to brachial artery ligation. 2 patients underwent simultaneous median nerve repair. In 3 patients we used fasciotomy. 6 patients developed arterial occlusion following vascular reconstruction and in one of them it was necessary to perform amputation. 2 patients had wound infection with saphenous vein repair disruption. Both were treated with brachial artery ligation and one underwent amputation. One patient died on the post operative period owing to associated lesions. Limb preservation was achieved in 47 patients (94%). 33 (70.2%) had no neurological deficit and 14 (29.7%) had some degree of neurological deficit. None of the patients had venous hypertension at the time of discharge.

Adolescent↗
PubMed2005

The two-stage brachial artery-brachial vein autogenous fistula for hemodialysis: an alternative autogenous option for hemodialysis access.

The optimal dialysis access for the patient with chronic renal failure is considered to be an autogenous fistula; this is reflected in the recommendations of the National Kidney Foundation-Disease Outcomes Quality Initiatives (NKF-DOQI). If adequate superficial veins at the wrist or the forearm are not available, the next option is usually a prosthetic arteriovenous graft. In this case series, we describe our experience with an autogenous fistula constructed using the brachial vein. There were 20 patients over a 14-month period who were operated on for dialysis access. In these patients, no adequate superficial veins were found at operation. Instead of using a prosthetic graft, we performed a brachial artery-brachial vein fistula in two stages. The first stage involved a forearm anastomosis and then subsequently, weeks later, this fistula was "superficialized." Twenty patients underwent a brachial artery-brachial vein fistula. Of these patients, all had successful maturation of their fistula and after a minimum waiting period of 12 weeks for maturation; all but one were able to be successfully dialyzed through their fistula. One patient developed arm swelling due to previously placed subclavian vein pacemaker wires. None of the other patients developed arm swelling or vascular steal. The brachial artery-brachial vein fistula is a feasible option for hemodialysis access and we suggest that this option be considered before a prosthetic arteriovenous graft is inserted. Arm swelling and steal have not been a problem, and all patients have been able to have full dialysis through the fistula after appropriate maturation times.

Adult↗
PubMed1993

Comparison of axillary artery or brachial artery pressure with aortic pressure after cardiopulmonary bypass using a long radial artery catheter.

Arterial pressure measured in a peripheral artery may significantly underestimate central arterial pressure after discontinuation of cardiopulmonary bypass (CPB). Arterial pressure measured with a 50 cm radial artery catheter advanced into the brachial or axillary artery was compared to ascending aortic pressure in 31 patients before and after discontinuation of CPB. The radial artery catheter extended proximally into the brachial artery in 8/31 patients, and into the axillary artery in 23/31 patients. The patient's age, pre-CPB cardiac ejection fraction, and surgical procedures were similar in both groups. The systolic arterial pressure measured in the ascending aorta was found to be significantly different from that in the axillary artery after CPB, whereas the mean and diastolic pressures were not. The average aorta-to-axillary artery systolic pressure gradient was -3.0 +/- 4.0 mmHg, with no patient having a gradient greater than 10 mmHg. The systolic and mean arterial pressures measured in the ascending aorta were found to be significantly different from that in the brachial artery after discontinuation of CPB, whereas the diastolic pressure was not. The average aorta-to-brachial artery systolic pressure gradient was 6.9 +/- 6.9 mmHg, with 3/8 patients having a gradient greater than 10 mmHg. Long radial artery catheters, placed using the Seldinger technique, provide an accurate estimate of central aortic pressure after CPB when they are advanced into the axillary artery. Sites more distal than the axillary artery may result in significant underestimation of the central aortic pressure in these patients.

Aged↗
PubMedDate not supplied

Brachial artery to brachial vein preserved vein allograft fistulas for hemodialysis.

Vein allografts were obtained from varicose vein patients in whom stripping and ligation was indicated. Proximal 30 cms of the long saphenous vein was removed and stored at -30 degrees C. A-V fistulas were constructed in the upper arm between brachial artery and the brachial or cephalic vein in dialysis patients. All these allograft vein recipients had major blood groups identical to the donors. Clinical experience over a two year period revealed a 100% long term patency. Complications including early graft thrombosis, superficial wound infection, hematoma formation and local edema were few and easily managed. Allograft rejection was not a problem in this series of patients. The large diameter grafts in upper arm position function well. They are convenient for the patient and preferred by dialysis personnel as a direct site for venepuncture. An initial experience suggests that preserved vein allografts may become the preferred material for arteriovenous fistulas.

Arteriovenous Shunt, Surgical↗
PubMed2001

Absence of the brachial artery: report of a rare human variation and review of upper extremity arterial anomalies.

Variations in the arterial anatomy of the upper extremities, although uncommon, occur in up to one in five patients. Most of these variants occur in either the radial or ulnar artery; brachial artery variations are less common. The case we report is a rare anomaly consisting of brachial artery agenesis or regression. The brachial artery was absent from its origin but reconstituted as a normal-appearing vessel 3 cm above the antecubital fossa. The profunda brachii artery and the superior and inferior ulnar collateral arteries were also absent in this patient. The axillary artery served as the main collateral to the forearm. This constellation of anomalies has not been previously described or explained by developmental models in humans and other primates. We speculate that failure of development or arrest of specific vascular anlage in the upper extremity occurs at particular embryological stages because of unknown factors.

Angiography↗
PubMed1988

Increased response of brachial artery diameter to norepinephrine in hypertensive patients.

The hyperresponsiveness of small arteries to norepinephrine is well documented in essential hypertensive patients. Our objective was to investigate in situ the reactivity to norepinephrine of the diameter of large arteries, which are involved in the arterial disease of hypertension as well as small arteries. Brachial artery diameter, blood flow velocity, local volumic blood flow, and local vascular resistances were determined noninvasively with a pulsed Doppler system in 19 patients with essential hypertension and 9 normotensive subjects, before and after the administration of placebo (glucose) or increasing doses of norepinephrine (10, 20, and 40 ng.kg-1.min-1 iv) given in a single-blind fashion. In hypertensive patients, norepinephrine (40 ng.kg-1.min-1) induced 1) a significant decrease in brachial artery diameter, local blood velocity, volumic flow, and conductance and 2) a small increase in mean arterial pressure. These hemodynamic changes did not occur in the placebo group and were significantly greater in hypertensive patients than in normotensive subjects, although plasma norepinephrine increased to the same extent in both groups. We conclude that in hypertensive patients the increase in vascular reactivity to norepinephrine involves not only the resistive vessels but also the large arteries thus decreasing their conducting and buffering function.

Adult↗
PubMed2002

Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force.

Endothelial function is thought to be an important factor in the pathogenesis of atherosclerosis, hypertension and heart failure. In the 1990s, high-frequency ultrasonographic imaging of the brachial artery to assess endothelium-dependent flow-mediated vasodilation (FMD) was developed. The technique provokes the release of nitric oxide, resulting in vasodilation that can be quantitated as an index of vasomotor function. The noninvasive nature of the technique allows repeated measurements over time to study the effectiveness of various interventions that may affect vascular health. However, despite its widespread use, there are technical and interpretive limitations of this technique. State-of-the-art information is presented and insights are provided into the strengths and limitations of high-resolution ultrasonography of the brachial artery to evaluate vasomotor function, with guidelines for its research application in the study of endothelial physiology.

Brachial Artery↗
PubMed2003

Age affects proximal brachial artery stiffness; differential behavior within the length of the brachial artery?

With increasing age, the diameter of central elastic arteries increases, whereas their distensibility decreases. The purpose of this study was to investigate the mechanical properties of the proximal brachial artery in relation to age and gender. Distensibility coefficient (DC), stiffness and compliance coefficient (CC) were calculated in 136 healthy males and females (range 9-82 y) using echo-tracking sonography. CC decreased with age in both genders, but CC was higher in males. Stiffness increased and DC decreased with age in an exponential manner, without any differences between genders. In conclusion, as in central elastic arteries, the distensibility of the proximal brachial artery decreases with age, in contrast to earlier reports on the muscular distal brachial artery. This may imply that the transition between elastic and muscular artery behavior is within the length of the brachial artery. In future studies using the brachial artery, the examination site needs to be defined.

Adolescent↗
PubMed2002

Comparison of carotid intima-media thickness, arterial stiffness, and brachial artery flow mediated dilatation in diabetic and nondiabetic subjects (The Chennai Urban Population Study [CUPS-9]).

This study compares flow-mediated dilation (FMD) and the augmentation index (AI) in diabetic and nondiabetic subjects and correlates these measurements with carotid intima-media thickness (IMT). Fifty diabetic subjects and 50 age- and sex-matched nondiabetic control subjects were recruited from the Chennai Urban Population Study. IMT of the common carotid artery and FMD of the brachial artery were determined using high-resolution B-mode ultrasonography. AI was measured using the Sphygmocor apparatus. The mean AI of diabetic subjects was significantly higher than the nondiabetic subjects (27.48 +/- 7.41% vs 19.10 +/- 8.19%, p <0.0001). The FMD values were significantly lower among diabetic subjects compared with the nondiabetic subjects (2.1 +/- 2.95% vs 6.64 +/- 4.38%, p <0.0001). At any given age point, diabetic subjects had significantly higher AI and lower FMD values compared with nondiabetic subjects (p <0.05). In the total population, AI and FMD showed a correlation with age (p <0.001), fasting plasma glucose (p <0.01), glycosylated hemoglobin (p = 0.001), and IMT (p = 0.001). Among the nondiabetic subjects, FMD and AI showed a strong correlation with IMT. FMD also showed a strong correlation with age and systolic blood pressure, whereas AI showed a correlation with fasting plasma glucose in diabetic subjects. AI and FMD values showed a strong correlation with age. AI values increased and FMD values decreased with an increase in quartiles of IMT both in diabetic and nondiabetic subjects. Multivariate linear regression analyses in the total study population showed that age and glycosylated hemoglobin were the risk factors associated with AI and FMD, in addition to diastolic blood pressure with AI. Diabetic patients have decreased FMD and increased arterial stiffness compared with age- and sex-matched nondiabetic subjects. These functional changes correlate well with the structural changes of the arteries measured by IMT.

Blood Flow Velocity↗
PubMed2004

The effect of sympathetic stimulation on proximal brachial artery mechanics in humans--differential behaviour within the length of the brachial artery?

AIMS: The mechanical properties of arteries play a major role in the regulation of blood pressure and cardiac performance. The effect of sympathetic stimulation on the mechanical properties of the proximal brachial artery was analysed in 18 healthy volunteers, nine young (25 +/- 2 years) and nine elderly (69 +/- 2 years). METHODS: A non-invasive ultrasonic echo-tracking system for measurement of systolic/diastolic variation of the proximal brachial artery diameter in combination with intra-arterial pressure measurements was used to determine wall mechanics. The pressure-diameter (P-D) relationship, distensibility coefficient (DC), compliance coefficient (CC) and stiffness(beta) were obtained at rest and during sympathetic stimulation induced by lower body negative pressure (LBNP). RESULTS: The peripheral vascular resistance increased by 100 and 72%, respectively in the young and elderly during LBNP (P < 0.001). Simultaneously, the mechanical properties of the proximal brachial artery remained unaltered, as estimated from both P-D relationship and stiffness in young (beta-index rest: 5.2 +/- 0.9, LBNP: 5.5 +/- 1.3, NS) as well as elderly (beta-index rest: 13.6 +/- 4.6, LBNP: 16.1 +/- 4.7, NS). CONCLUSIONS: LBNP-induced sympathetic activation does not change proximal brachial artery mechanics, in contrast to earlier reports on the muscular distal brachial artery. This may imply that the transition between elastic and muscular artery behaviour is within the length of the brachial artery, where the site of transition from elastic to muscular wall structure needs to be specified in future studies.

Adult↗
PubMed1995

Anomaly of the ulnar artery arising from the brachial artery.

A high origin of the ulnar artery was encountered in the body of an 87-year-old Japanese man in the course of normal anatomic dissection at Nara Medical University. The left ulnar artery originated from the brachial artery at the height of the left inferior angle of the left scapula and passed medially to the brachial artery and the median nerve. In the forearm, the ulnar artery passed deep to the flexor carpi ulnaris muscle. Thereafter, the two branches from the ulnar artery contributed to form the superficial and deep palmar arterial arches. The left brachial artery was divided into two terminal branches of the radial and common interosseous arteries.

Aged↗
PubMed1984

Delayed, distant arterial injury after brachial artery catheterization.

The occurrence of iatrogenic arterial injury secondary to catheterization for angiographic studies has been well documented in the literature for over a decade. It has been well established that patients should be carefully evaluated post-catheterization and if absence of the pulse distal to the arteriotomy site is discovered, most should undergo exploration for identification and correction of the problem. Between 0.3 and 24% of patients undergoing brachial artery catheterization have been found to have a diminished or absent radial pulse after the procedure. In the vast majority of cases the problem has been solved by local exploration of the arteriotomy site. However, in a small but definite number of cases late thrombotic complications have become manifest, and in two cases reported in 1981 and in the case report to follow, thrombotic complications have become manifest months later, secondary to injury well proximal to the arteriotomy site.

Brachial Artery↗
PubMed1997

Rare case of high origin of the ulnar artery from the brachial artery.

Arterial variations in the arm are numerous and occur at the level of the axillary, brachial, radial, and ulnar arteries as well as in the palmar arches. We report on a high branching site of the ulnar artery. A high branching brachial artery was found in a 72-year-old white female during a dissection course. The brachial region was then dissected carefully and the preparation steps were documented. The axillary artery, after entering the arm, was located posterior to the junction of the two roots of the median nerve, just 2 cm distal to the latter, and divided into the ulnar and the radial arteries. The radial artery was located medial to the median nerve in the arm and approached the lateral side of the arm to reach the cubital fossa. Just distal to its origin, the ulnar artery ran laterally crossing ventral to the median nerve, thereafter supplying the biceps brachii muscle with three branches from a common stem. The ulnar artery then approached the medial side of the arm, crossed ventral to the median nerve again and took its course toward the cubital fossa as usual. This high bifurcation of the brachial artery and the abnormal course of the ulnar artery is of interest to clinicians; in particular vascular and plastic surgeons and radiologists.

Aged↗