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During a routine dissection a superficial artery was observed coursing subcutaneously at the anterior border of the axillary base towards the thoracic wall and bilaterally at the lower border of the pectoralis major muscle. On the right side it originated from the 3rd part of the axillary artery but on the opposite side the origin was from the first centimetre of a left radial artery originating directly from the axillary artery together with the left brachial artery. Apart from the bilateral absence of the deep brachial artery, no other anomalies were identified at this level. This variant corresponds to the alar thoracic artery, an unusual and rarely reported artery. The literature on the subject contains no reference either to the bilateral evidence for the alar thoracic artery or to the possibility of an origin from a high radial artery. The presence of such an alar thoracic artery may interfere with surgical access within the axillary fossa and should be taken into consideration.
Radial artery variations are of importance for clinicians, whether in angiographic examinations or surgical approaches. The high origin radial artery is the most frequent arterial variation observed in the upper limb, showing an incidence of 14.27% in dissection material and 9.75% in angiographic examination. In the present study an unusual course of the radial artery and its relation with the median nerve has been evaluated. During embryological development the radial artery sprouts from two arterial buds arising from the lateral side of the brachial artery and coalescing with each other. The artery lies in the forearm and is overlapped by the brachioradial muscle. In this particular case the radial artery originated from the medial side of the brachial artery and crossed the median nerve twice in an unusual manner 8 cm below the point at which the deep brachial artery arose and 12 cm above the intercondylar line. These results will enhance anatomical knowledge of the region and reduce complication in surgical approaches.
In this article we describe a unique and complex variation in the arterial pattern of the left hand of a female cadaver. The following variations were found in this case: a) persistent median artery of the palmar type, terminating in the hand as the princeps pollicis and radialis indicis arteries; b) the ulnar artery giving only two common palmar digital arteries; c) the second digital palmar artery without division into two digital branches and instead supplying only the radial side of the ring finger; d) absence of the first common digital artery with the contiguous sides of the second web space supplied by the first palmar metacarpal artery from the deep palmar arch; e) early bifurcation of the median nerve proximal to the flexor retinaculum.
The use of radial arteries as an arterial bypass conduit is an invasive procedure which is becoming popular among various medical centres. The greatest risk associated with harvesting the radial artery is ischaemia of the soft tissues of the hand. In this study we dissected 200 hands derived from 100 formalin-fixed cadavers in order to identify arterial patterns that will allow safe removal of the radial artery for use in bypass procedures. A complete superficial palmar arch (SPA) was found in 90% of the cases and divided into 5 types, while the remaining 10% possessed an incomplete palmar arch. Types of SPA are designated by the letter S. In type S-I (40%), the SPA is formed by anastomosis of the superficial volar branch of the radial artery to the ulnar artery. Type S-II (35%) is formed entirely of the ulnar artery. Type S-III (15%) is formed by anastomosis of the ulnar and median arteries. Type S-IV (6%) is formed by anastomosis of the ulnar, radial, and median arteries and Type S-V (4%) is formed by a branch of the deep palmar arch (DPA) communicating with the SPA.DPA was identified in all specimens and classified into three types, all designated by the letter D. Type D-I (60%) is formed by anastomosis of the deep volar branch of the radial artery and the inferior deep branch of the ulnar branch. Type D-II (30%) is formed by anastomosis of the deep volar branch of the radial artery and the superior deep branch of the ulnar artery. Type D-III (10%) is formed by anastomosis of the deep volar branch of the radial artery with both deep branches of the ulnar artery. This data could provide an important source of information for vascular surgeons harvesting radial arteries.
A vessel connecting the axillary or brachial artery to one of the forearm arteries was found in a 65 year old male cadaver, during the gross anatomy dissection of the upper extremity of 20 adult cadavers at the Department of Cellular Biology and Anatomy, Louisiana State University Medical Center. The right radial artery originated from the brachial artery nearly at the usual level and was connected to the axillary or brachial artery by a long slender anastomotic artery (vasa aberrantia). The anastomotic artery coursed under the medial side of the biceps muscle between the median and musculocutaneous nerves, and gave off two muscular branches to the biceps muscle. The anastomotic artery coursed between the median and musculocutaneous nerves in the arm, it passed to the forearm under the bicipital aponeurosis and connected the main radial artery on the radial side of the forearm. The anastomotic artery can be explained on the basis of its embryologic development and also ought to be distinguished from the other common arterial variations in the upper extremity.
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