Padrão venoso superficial da fossa cubital: revisão sistemática de literatura e metanalise

Abstract

The superficial venous system of the upper limb exhibits high anatomical variability in the cubital fossa region as a result of embryonic development and vascular remodeling. The cephalic, basilic, median antebrachial, and median cubital veins constitute the main components of this system, establishing different patterns of communication that are considered normal anatomical findings. These variations have significant clinical relevance, particularly during venipuncture procedures, as they influence the relationship of the veins to adjacent structures, such as nerves and arteries, directly impacting patient safety. In light of this, the present study investigated the superficial venous patterns of the cubital fossa. This is a systematic review conducted in accordance with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), with the protocol registered in PROSPERO. The search was conducted in seven electronic databases, including PubMed, Scopus, Embase, Web of Science, ScienceDirect, the Cochrane Library, and LILACS, using the search terms “anatomy,” “forearm,” “vein,” and “cubital fossa.” Observational anatomical studies describing morphological variations of the superficial veins of the cubital fossa in humans were included. Methodological quality was assessed using the Anatomical Quality Assurance (AQUA) tool, and, when possible, the data were subjected to meta-analysis using the random-effects model (p < 0.05). Superficial venous pattern Type 1 had the highest pooled prevalence, followed by Types 2 and 3. Types 4 and 5 had intermediate prevalences, while Types 6 through 11 corresponded to rare variants, with a prevalence of less than 1%. No statistically significant differences were observed with respect to sex and laterality, while only Type 4 showed a significant difference among the geographic regions analyzed. These findings reinforce the high anatomical variability of the region and highlight the importance of understanding these patterns for procedure planning, contributing to greater safety in clinical practice. It is concluded that Type 1 superficial venous pattern is the most prevalent in the cubital fossa, followed by Types 2 and 3. No significant association were observed between genders or laterality, although Type 4 showed a higher frequency in Middle Eastern populations.