Bilateral palmar type of persistent median artery: A case report

Abstract

The persistent median artery (PMA) is an example of a supernumerary artery in the forearm. During embryonic development, the median artery regresses as the ulnar and radial arteries take over the blood supply of the forearm. Non-regression of the median artery will lead to its persistence into adulthood. We are reporting a bilateral presence of a palmar type of PMA, which was a branch of the ulnar artery, and the PMA passed through the carpal tunnel to supply the hand. On the right side, PMA pierced the median nerve in the upper forearm. In the palm, PMA did not form the superficial palmar arch. However, a communicating twig between the PMA and ulnar artery was observed on the left side. The presence of PMA could cause compression of the median nerve, leading to carpal tunnel syndrome. PMA of larger calibre could be used as a graft and in harvesting reconstructive free flap. Knowledge about these vascular variations is important in diagnosing nerve compression syndromes and avoiding unanticipated surgical complications.