Upper limb vascular anomalies. Many upper limb vascular anomalies are associated with transradial approach failure and are classified according to ABC operative classification. Group A radial-brachial axis: radial tortuosity (Z shape) (A), radial loop (360°) (B), brachial tortuosity (C), brachial loop (D), high radial origin (E). Group B axillary-subclavian-anonymous axis: high radial origin (E), axillary stenosis (F), subclavian tortuosity (G), subclavian lousoria (H). Group C: aortic arch: aortic elongation (I)