An anatomical investigation of the radial artery and its distal segment in a select South African population.

Abstract

The radial artery and its distal segment are increasingly favoured as access points in neurointerventional procedures via the transradial approach, owing to their accessibility and lower complication rates compared to the transfemoral approach. The success of such procedures is influenced by factors such as vessel diameter, sheath compatibility and anatomical variations. Although the radial artery has been studied extensively in other populations, limited data exist for African cohorts, particularly within the South African population. Therefore, this study aimed to document the anatomical characteristics of the radial artery and its distal segment within a select South African sample. A mixed-method design was employed, comprising ultrasound investigation in a participant sample (n = 256, 128 adults and 128 paediatric patients) and cadaveric dissection of 30 adult body donors. The study was conducted at a central regional hospital in Durban, South Africa, and at the Department of Clinical Anatomy, University of KwaZulu-Natal. Ultrasound imaging measured the internal diameters of the distal forearm and snuffbox radial arteries, while dissection was used to determine the external and internal diameters, wall thickness at three levels (point of origin, wrist joint and anatomical snuffbox) and the origin of the radial artery. Ultrasound findings revealed mean diameters of 1.94 ± 0.39 mm for the distal forearm radial artery and 1.33 ± 0.31 mm for the snuffbox radial artery in adults, with males demonstrating significantly larger diameters. Paediatric measurements were notably smaller (1.12 ± 0.32 mm and 0.77 ± 0.20 mm, respectively). Cadaveric analysis demonstrated a progressive tapering of the artery from its point of origin toward the anatomical snuffbox. Approximately 55% of adults and 99% of paediatric patients had distal radial artery diameters less than 2.0 mm – the outer diameter of a 4 French sheath. Variations in the origin of the radial artery were also noted, with 10% displaying a high origin from the axillary artery. This study contributes to the literature by providing novel morphometric and morphological data based on a select South African population. The findings of the present study may assist clinicians during coronary, cardiovascular, neurological and neuro-interventional procedures within this select population.