title: Anatomical vascular variations and practical implications for access creation on the upper limb.
abstract: BACKGROUND
  A profound knowledge of vascular anatomy and an understanding of vascular access functionality with respect to possible complications are critical in selecting the site for arteriovenous anastomosis.
  
  
  METHODS
  Outline of vasculature variations of the upper limb with prevalence reported in literature of at least 1%, which may affect access creation, is depicted in this review.
  
  
  RESULTS
  Over a dozen arterial anatomical anomalies of the upper limb, the most common is "high origin" of the radial artery (12-20%). Superficial positions of brachial, ulnar and radial artery as well as accessory brachial are another possible anatomic variants (0.5-7%). The most variable venous layout on the upper arm is seen in the anatomy of the brachial vein and the basilic vein forming the axillary vein. Three types of basilic vein course on upper arm have been described.
  
  
  CONCLUSIONS
  The mapping technique to assess vascular variants facilitate site selection for AVF creation even in cases with previously attempted failed access (misdiagnosed vascular variant could force to secondary options). Thus, a thorough understanding and evaluation of anatomy, taking into consideration the possible vascular variations of the forearm and upper arm, are necessary in the planning of AVF creation and increase the success of AVF procedures.
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw - Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Kusztal
authors.forename: Waclaw
authors.initials: W
authors.lastname: Weyde
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Letachowicz
authors.forename: Tomasz
authors.initials: T
authors.lastname: Gołebiowski
authors.forename: Waldemar
authors.initials: W
authors.lastname: Letachowicz
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000379:methods*; D001367:Axillary Vein / Q000002:abnormalities / Q000503:physiopathology; D001916:Brachial Artery / Q000002:abnormalities / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D017534:Radial Artery / Q000002:abnormalities / Q000503:physiopathology; D006435:Renal Dialysis; D016896:Treatment Outcome; D017535:Ulnar Artery / Q000002:abnormalities / Q000503:physiopathology; D034941:Upper Extremity / Q000098:blood supply*; D054079:Vascular Malformations / Q000175:diagnosis* / Q000503:physiopathology