Aberrant Radial Artery Research Articles

Anatomical obstacles and their impact on the sheath to balloon time while intervening through a trans-radial approach in patients undergoing primary percutaneous coronary intervention

Abstract Funding Acknowledgements Type of funding sources: None. Background Trans-radial approach has been considered a safe and useful vascular access site for cardiac catheterization in comparison with the conventional trans-femoral approach. However, radial access has many challenges, such as access difficulty related to anatomical variations, radial artery spasm, occlusion, loops, tortuosities, and aberrant origin of radial and subclavian arteries. These factors were ignored in the large randomized trials that might have a significant impact on the outcome. Purpose To determine the predictors of anatomical obstacles and their impact on the sheath to balloon time while intervening through a trans-radial approach in patients undergoing primary percutaneous coronary intervention. Methods This was a case-control study comprised of 466 patients who underwent primary percutaneous coronary intervention to determine the predictors of anatomical obstacles including radial artery spasm, radioulnar loops, aberrant radial artery, tortuous configuration, and subclavian tortuosity. Sheath to balloon time was determined in both the groups with and without anatomical obstacles. Results Patients with and without anatomical obstacles were recruited in a 1:3 ratio. Female gender was found to be associated with anatomical obstacles with the distribution of 28.6% (32/112) vs. 19.2% (68/354); p = 0.035 for the patients with and without anatomical obstacles. Patients with obstacles were comparatively older than patients without obstacles with the mean age of 59.11 ± 8.86 vs. 55.6 ± 9.45 years; p < 0.001. Diabetes as co-morbid was another clinical factor observed to be associated with the presence of anatomical obstacles with the distribution of 50.9% (57/112) vs. 40.1% (142/354); p = 0.044 for with and without obstacles cohort respectively. Among patients with anatomical obstacles, the most common type of obstacle was observed to be subclavian tortuosity (40.2%) followed by radial artery spasm (25.9%), tortuous configuration (17.0%), radioulnar loop (12.5%), and abnormal origin of the RA (4.5%). A significantly higher sheath to balloon time was observed for the patients with anatomical obstacles as compared to those without with a mean duration of 30.92 ± 13.25 vs. 19.42 ± 6.2 minutes; p < 0.001. Conclusion Older age, female gender, and diabetes were found to be the major predictors for anatomical obstacles and hence significantly increasing the sheath to balloon time. Moreover, Subclavian tortuosity was the most common obstacle followed by the radial artery spasm. Therefore, predicting the factors prolonging the procedure time could be beneficial to select the access site and can improve the overall outcome.

ARTERIOVENOUS FISTULA IN A PATIENT WITH ABERRANT RADIAL ARTERY

Abstract Arteriovenous fistula is the most commonly used vascular access in patients on maintenance hemodialysis. Operating surgeon has to be aware about the normal anatomy of vessels as well as variations in the course of the vessels. Here wereport a case of radiocephalic arteriovenous fistula constructed in aberrant radial artery. This is the first case of arteriovenous fistula with aberrant radial artery to be reported in world literature.

A High Bifurcation of the Dorsal Branch with Dominant Superficial Palmar Branch of the Radial Artery: A Case Report of an Aberrant Radial Artery with Traumatic Aneurysm

Anatomical abnormalities such as unusual bifurcations or aberrant arteries of the radial artery are extremely rare and due to malformation or disruption of the vascular net. We present a case of a 64year old woman with a high bifurcated dorsal branch of the left radial artery, consulting us for a pulsatile mass in the anatomical snuffbox after a fall. The mass measured 3-4mm in diameter and was located on the dorsal aspect of the wrist over the anatomical snuffbox. Primary imaging studies using Duplex Ultrasound suggested an aneurysm of the radial artery, further imaging with arteriogram revealed a high bifurcation of the dorsal branch of the radial artery, presenting with an aneurysm. The deep palmar branch of the ulnar artery was the dominating vessel, allowing ligation and excision of the aneurysm. Histological evaluation revealed intimal wall hyperplasia within the aneurysm, suggesting an injury as initiating factor. A review of the literature showed that this abnormality of high bifurcation of the dorsal palmar branch of the radial artery has not been previously reported. Management of aneurysms at the wrist is discussed.

Aberrant Origin of Radial Artery in Arm

During dissection in middle-aged male cadaver, an aberrant radial artery was noticed in the left arm. The artery was taking origin from the upper part of the brachial artery i.e. at a point when axillary artery leaves the axilla and becomes brachial artery.Course of the aberrant vessel was studied in the arm and the forearm. In the upper part of arm the vessel took origin on the lateral side of brachial plexus trunks and traveled to the lateral region of the cubital fossa travelling lateral to the biceps brachii and deep to skin, superficial and deep fascia. In the lower part of the arm i.e. just above the cubital fossa, aberrant vessel was lateral and entered the forearm deep to the pronator teres. Throughout its course the vessel laid superficial to forearm muscles, it was covered by the skin superficial and deep fascia. At the wrist its position was normal i.e. against anterior border of the radius.

An unintended cannulation of aberrant radial artery!

An unintended cannulation of aberrant radial artery!

Accidental cannulation of aberrant radial artery

Accidental cannulation of aberrant radial artery

Unintentional Cannulation of Aberrant Radial Artery: Review and Treatment Recommendations

We present the case of a patient who had an unintentional placement of an arterial catheter in an aberrant radial artery. This arterial abnormality is reviewed, as are the potential consequences of intra-arterial injection. Finally, treatment reco-mmendations are summarized.  

Acute Upper Limb Ischemia in Patient with Aberrant Radial Artery

Acute Upper Limb Ischemia in Patient with Aberrant Radial Artery

Acute Upper Limb Ischemia in Patient with Aberrant Radial Artery

Upper limb arterial variations are frequently discovered at cadaver dissection, in clinical or surgical settings. We report the case of a female patient with acute upper limb ischemia due to a thrombosed brachial artery. At operation, an aberrant radial artery (ARA) was found, resembling the brachial artery. Further identification of the brachial artery deep to ARA leads to successful revascularization.

Aberrant Radial Artery Seen in the Carpal Tunnel at Carpal Tunnel Decompression: Case Report

We present a case in which the radial artery was found running within the carpal tunnel at the time of routine carpal tunnel decompression. It appears to be an anomalous superficial palmar branch of the radial artery that is substituting for the normal radial artery.

Accidental cannulation of an aberrant radial artery

Accidental cannulation of an aberrant radial artery

Thenar hypoplasia in Klippel-Feil syndrome due to aberrant radial artery

A 10-year-old boy with Klippel-Feil syndrome had progressive atrophy of the left thenar eminence and absence of left radial pulse. Neurophysiologic studies and angiography were normal. However, duplex sonography over the wrists revealed an aberrant left radial artery. We speculate that the thenar atrophy in this patient is congenital, which may be due to the anomaly of the left radial artery, and is further compromised by vascular compression in the thoracic outlet.

The aberrant radial artery and Valsalva's experiment

The Journal of PhysiologyVolume 46, Issue 3 p. 184-187 ArticleFree Access The aberrant radial artery and Valsalva's experiment James M. McQueen, James M. McQueenSearch for more papers by this authorWm. F. Croll, Wm. F. CrollSearch for more papers by this author James M. McQueen, James M. McQueenSearch for more papers by this authorWm. F. Croll, Wm. F. CrollSearch for more papers by this author First published: 19 June 1913 https://doi.org/10.1113/jphysiol.1913.sp001587AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume46, Issue3June 19, 1913Pages 184-187 RelatedInformation