The Prevalence of the Tortuous Upper Limb Arteries and Its Effects on the Histological Structure of the Arterial Walls

Change in the direction of the flow of blood in the tortuous vessel could affect the histological structure of the vessel and so causing atherosclerotic plaque. In particular, the tortuous cause of the radial artery can cause difficulty in access during transradial catheterisation. Tortuosity could hinder the passage of the catheter and hence cause complications in the success of the arterial catheterisation. Therefore, these variant arterial patterns have an impact on planning and success of surgical procedures. However, the prevalence and effect of tortuosity has not been sufficiently recorded in literature. The aim of this study is to record the prevalence of tortuosity of upper limb arteries and its effect on the histological structure of the vessels. Arteries from 180 upper limbs of 90 cadavers were dissected in the Department of Anatomy at Sefako Makgatho Health Sciences University (ethics number: SMUREC/M/193/2022: PG). Proximal, tortuous, and distal segments of the arteries were harvested and processed for histological analyses of wall thickness and connective tissue changes. Tortuous arteries were recorded in 42/180 cases. 15/180 tortuous arteries were the brachial arteries, while 27/ 180 were radial arteries. The tunica intima was significantly thicker in the tortuous segment compared to the proximal segment (p = 0.007). The connective tissue area fraction of the tunica media was significantly higher in the distal segment of the tortuous artery (p = 0.027). Tortuosity was more prevalent in the radial artery, whereby it caused significant thickening of the tunica intima, potentially increasing the risk of arteriosclerotic plaques.