Dorsal Branch Of Radial Artery Research Articles

Innominate variant artery in the first web space

Numerous variations are characteristic for hand anatomy. Although a lot of work has been done in the field, a detailed description of the branches of the radial artery is still missing. The aim of this study is to determine the incidence and diameter of the accessory artery, which can be found running on the dorsal surface of the interosseus dorsalis primus muscle, to deliver the detailed description of this arterial variation and based on that to suggest a systematic name of the artery which would be in line with Terminologia Anatomica. We used 133 complete donor bodies and 237 cadaverous hands in our study, giving us a total sample size of 503 samples. When possible, we determined the age of the donors which was between 62 and 90 years. We performed detailed anatomical dissection to determine the individual branching. We also measured the diameter of selected arteries. When relevant we performed statistical comparisons. To do that we first applied Shapiro-Wilk test to determine the normality of distribution and after that we used Mann-Whitney U test and One-way ANOVA. The variation of interest was found in 11.93% of cases. Based on the anatomical differences we determined four types of branching, type 1-3 forming the anastomosis with superficial palmar arch (being considered as positive findings) and type 4 which did not form this anastomosis (thus considered to be a negative finding). We successfully determined the incidence of this arterial variation on a sufficient sample size. We also described the anatomy of this branching in detail and were able to determine four types of this branching. After careful consideration of these findings we proposed the new name for this artery and suggest to use the name superficial dorsal branch of radial artery. This could contribute to a better understanding of this branching and potential use in clinical practice.

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.

Radial artery cannulation decreases the distal arterial blood flow measured by power Doppler ultrasound.

Radial arterial cannulation is a popular technique for continuous hemodynamic monitoring in an area of anesthesia and intensive care. Although the risk for invasive monitoring is considerable, there is scarce information about the change in blood flow of cannulated vessel after the catheterization. In the current investigation, we evaluated the change in the cannulated arterial blood flow. Six volunteers (study 1) and eight post-surgical patients (study 2) were enrolled into the studies. In the study 1, the both side of diameter of radial artery (RA), ulnar artery (UA) and dorsal branch of radial artery (DBRA) of participants were measured using power Doppler ultrasound (PDU) with or without proximal oppression. In the study 2, the diameter of RA, UA and DBRA of the both intact and cannulated side were compared. Study 1: The diameter of RA was 3.4 (0.52) [mean (SD)] mm and the proximal oppression significantly decreased the diameter to 1.8 (0.59) mm. The diameter of DBRA measured by PDU also decreased 2.0 (0.60)-1.3 (0.59) mm. Study 2: There was no difference between the diameters of right and left RA, however, the UA was larger [3.4 (0.60) vs. 2.8 (0.83) mm] and the DBRA was narrower [1.4 (0.43) vs. 2.0 (0.47) mm] in the cannulated side. The diameters of DBRA were different between the intact and cannulated side in the patients. Although there is no information of relationships between cause of severe complication and decreased flow, significant reduction of blood flow should be concerned.

Vascularized surgical rotation of a bi-articular trapezoid-trapeziometacarpal complex for the treatment of severe rhizarthrosis of the thumb

A new surgical procedure has been conceived to avoid persistent pain and to restore the functionality and pinch strength of the basal joint of the thumb destroyed by degenerative osteoarthritis. Since January 1998 a double total joint transposition was performed on eight patients, switching the trapezoid-metacarpal joint and the trapezio-metacarpal joint. A 180 degrees rotation of the bi-articular complex (trapezoid-trapezio-metacarpal joints) in its entirety was achieved, while preserving the intrinsic ligaments and vascular supply insured by the dorsal branch of the radial artery; the Cardan conformation in Physics of the trapezoid-metacarpal joint provided complete thumb motion. skin dorso-radial approach of the wrist; arteriolysis of the dorsal branch of the radial artery at the anatomic snuff box and at its entrance into the first intermetacarpal space; metaphyseal osteotomy of the first and second metacarpal; capsulotomy all around the bi-articular complex; transfer and rotation of the trapezoid-trapezio-metacarpal bi-articular complex together with the dorsal branch of radial artery; osteotomy stabilisation by Kirschner wires; capsulo-ligamentous reconstruction; plaster slab immobilisation. Four weeks later the thumb moves actively; hand therapy starts six weeks post-operatively. Clinical and radiological controls were performed at two, four and six weeks, tomography at three months post-operation. Clinical assessment for three patients showed three good results and for the other five showed excellent outcomes, resulting in complete motion, stability of the first metacarpal and restored painless pinch strength of the thumb. Today the trapezoid-metacarpal joint seems to ensure pain relief, mobility and to solve the instability due to the collapse of the thumb column by restoring the bone chain of the first metacarpal ray.