INTRODUCTIONThe superficial and deep palmar arterial arches are the main sources of blood supply to all structures in the human hand, and variations in these arterial arches are quite common. Although several studies have reported diameters and variations of these arches, to the authors' knowledge, no study has correlated such changes to handedness in adults. It is likely that dominance may play a role in arterial variations, such as those seen in the diameter or number of arteries formed in the palmar arches, much like in other areas of the human body. This cadaver study was conducted to determine any such association.

METHODS42 formalin-fixed hands were dissected to expose the superficial and deep palmar arches. These arches were then thoroughly examined for any variations between the dominant and non-dominant hands. All cadavers were noted to be right-handed as per hospital records.

RESULTS19 complete superficial arterial arches (right hand 14; left hand 5) were found in the 42 hands dissected.

CONCLUSIONMost complete superficial palmar arches were found in the dominant hand of the cadavers studied, and therefore, handedness may have a role to play in determining palmar arterial arch variations in humans. Due to dominance or handedness, some arteries may likely persist into adulthood while others may become obliterated, thus leading to variations. Dissection of foetal hands may help to shed more light on the persistence or obliteration of various arteries after birth. Knowledge of such variations may prove helpful for surgeons during hand surgeries.

Cadaver ; Functional Laterality ; Hand ; anatomy & histology ; physiology ; Hand Deformities ; Humans ; Radial Artery ; anatomy & histology ; Ulnar Artery ; anatomy & histology

The superficial brachial artery (SBA), a branch of the axillary artery, is one of the most common arterial variations in this area. While it is more vulnerable to accidental arterial injection or injury, it could be useful for the nourishment of a medial arm skin free flap. To analyze the relationship between the SBA of axillary origin and segmental variation of the axillary artery, we dissected 304 arms of Korean cadavers. We found an SBA of axillary origin in 12.2% of cadaveric arms. Unilateral occurrence was detected in 16 cadavers and bilateral in 10. SBAs gave rise to radial and ulnar arteries in the cubital fossa (8.9%), continued in the forearm as the radial artery (2.3%), or ended in the upper arm (1.0%). The SBA ended as ulnar artery was not found in any of the cadavers. The bifurcation of the SBA into the radial and ulnar arteries, presence of an SBA that ends in the upper arm, and the lack of continuation as the ulnar artery are characteristics of SBAs in Korean cadavers.
Arm/*blood supply ; Axillary Artery/anatomy & histology ; Brachial Artery/*anatomy & histology/*physiology ; Cadaver ; Female ; Humans ; Korea ; Male ; Median Nerve/blood supply ; Models, Anatomic ; Radial Artery/anatomy & histology ; Ulnar Artery/anatomy & histology

BACKGROUNDThe radial artery is currently regarded as a useful approach for coronary intervention procedures. Adequate anatomical information of the radial artery should be helpful in performing transradial coronary procedures. Few data about the Chinese population have been obtained in this field. Therefore, we tried to evaluate the incidence and clinical significance of anomalous patterns, and their influence on the intervention procedure.

METHODSIn an estimated sample of 3000 cases, radial artery and subclavical artery angiography were performed after insertion of the sheath and coronary angiography (CA). The evaluable data including branch anomaly, tortuosity of the radial artery and procedural characteristics were analyzed. The procedure success was defined as CA or percutaneous coronary intervention (PCI) completed with the initial radial artery approach without changing to other routes.

RESULTSIn this study, 1897 cases of CA was undertaken and 1103 cases of CA combined with PCI were performed. The success rate of transradial intervention (TRI) was 96.6% (2899/3000). The approach in 44 cases was changed to the contralateral radial artery and 57 cases were changed to the brachial artery or femoral artery due to failure with the initial radial artery approach. The angiography of the upper limb artery was performed in all cases. Anatomic variations of upper limb arteries were noted in 610 patients (20.3%), which included tortuous configurations of the radial artery (5.0%), hypoplasias (2.2%), radioulnar loop (1.1%), abnormal origin of the radial artery (7.7%), stenosis of radial artery (1.4%), a tortuous configuration of the brachial artery (0.9%), a tortuous configurations of the subclavian artery (1.9%), lusoria subclavian artery (0.1%), and subclavian artery occlusion (0.03%). The procedural success rate in the normal population was higher than in the variation group (97.6% vs 93.0%, P < 0.001). In addition, other procedural outcomes and incidence of complications except radial artery occlusion were also significantly superior to variation group.

CONCLUSIONSAnatomic variations of the radial artery were common, making up an important limitation in the trans-radial approach. Selection of appropriate instruments and understanding some tips and tricks were helpful to overcome the obstacles and effectively reduce the learning curve.

Aged ; Angioplasty, Balloon, Coronary ; methods ; Coronary Angiography ; Female ; Humans ; Male ; Middle Aged ; Radial Artery ; anatomy & histology ; Treatment Outcome