A cadaveric study on the persistence of the median artery

Abstract

The median artery is a transitory artery that supplies blood to the forearm and hand of an embryo. This artery regresses at the 8th week of gestation upon the development of the radial and the ulnar arteries. However, the median artery may persist in adults and such persistence can lead to many complications including median nerve compression and related syndromes such as carpal tunnel syndrome, anterior interosseous nerve syndrome and pronator teres syndrome. The persistent median artery has been shown to be highly variable in its origin, and has been shown to arise either from the brachial, radial, ulnar, common interosseous or anterior interosseous arteries. The prevalence of persistent median arteries has a wide range, reported as 1.1% – 27.1%. Studies reporting the prevalence, origin of the persistent median artery and its contribution to the complete or the incomplete palmar arch have been highly variable. Additionally, no study has documented the prevalence of this artery in the population of donated cadavers within the UT Health San Antonio Human Anatomy Program. Furthermore, publications demonstrating the presence of other arterial variations in the upper extremity in association with the presence of the persistent median artery in this donated cadaver population are very limited. Awareness of such anatomical variations is extremely critical for clinicians performing reconstructive surgeries involving the arteries of the upper extremity to optimize patient outcomes.Specific aims of this study are 1. To determine the prevalence and the origin of the persistent median artery in this donated population of cadavers 2. To investigate whether the persistence of a median artery is associated with other arterial variations in the arm & the forearm 3. To elucidate the contribution of the persistent median artery to the complete or incomplete superficial palmar arch. To address these specific aims, 54 upper limbs of donated cadavers were surveyed. Preliminary data suggest the incidence of persistent median artery to be 29.63% (16/54). Furthermore, 25% (4/16) of the upper limbs with a persistent median artery presented with a high division (proximal to the cubital fossa) of the brachial artery into the radial and the ulnar arteries. Additionally, 43.8% (7/16) of these persistent median arteries entered the hand through the carpal tunnel and supplied the digits. 31.3% (5/16) of these persistent median arteries contributed to an incomplete superficial palmar arch and 12.5% (2/16) contributed to a complete superficial palmar arch. We are currently surveying more cadavers. Knowledge provided from this project will allow not only a better understanding of the prevalence of this artery, but also an understanding of clinical correlates that arise due to the presence of the persistent median artery.Support or Funding InformationNoneThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.