Comprehensive review of the superficial veins of the forearm from a historical, anatomical and clinical point of view

Abstract

The superficial veins of the forearm are prone to possess different patterns of anastomosis. This is highly significant, as venipunctures in the upper limb are among the most performed procedures in the world and they often rely on the veins of the cubital fossa. In addition, the relationship of these veins to the cutaneous nerves are also prone to vary and are often uncertain. These veins are also manipulated in the creation of arteriovenous fistula for dialisis, which remains as the best choice of treatment for renal failure patients. Such fistulas are often performed on the wrist or the cubital fossa, with the cephalic vein or basilic vein. It is known that anatomical variations of the vessels and nerves on the cubital fossa may induce the professionals to error, and one of the most common complications of venipuncture are accidental nerve puncture, which can lead to paresthesia and pain. We aim to perform a comprehensive review of the venous arrangements of the cubital fossa and their clinical aspects, as well as of venipuncture from a historical perspective and of the complications of venipuncture and arteriovenous fistula from an anatomical point of view, with the purpose of compiling available data and help healthcare professionals to reduce puncture errors or arteriovenous fistula complications and improve patient care.