Congenital Bilateral Absence of the Radial Artery: A Very Rare Variation in Humans - Phylogenetic and Ontogenetic Aspects

Pretterklieber, Bettina; Martschini, Gerda; Pretterklieber, Michael L.

doi:10.1159/000450575

Cited by 5 publications

(5 citation statements)

References 13 publications

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“…Thus, the hand collateral supply is more likely to be compromised by the PMA intraoperative ligation. Recent cadaveric reports pointed out the PMA coexistence with super cially located, absent, and ectopic vessels in the upper limb [5,14]. Pretteklieber et al [14] published a rare unilateral PMA coexistence with a RA bilateral absence.…”

Section: Discussionmentioning

confidence: 99%

“…Recent cadaveric reports pointed out the PMA coexistence with super cially located, absent, and ectopic vessels in the upper limb [5,14]. Pretteklieber et al [14] published a rare unilateral PMA coexistence with a RA bilateral absence. The PMA may also coexist with muscles' atypia, like a reverse or absent palmaris longus [11,18], an accessory lumbrical [2] and an accessory exor carpi ulnaris muscle [18].…”

Section: Discussionmentioning

confidence: 99%

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Median artery bilateral persistence in coexistence with a bifid median nerve and a communication with the ulnar nerve and vice-versa

Piagkou

Tsakotos

Triantafyllou

et al. 2023

Preprint

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Purpose The current report describes the bilateral coexistence of a persistent median artery (PMA) of ulnar origin and asymmetrical termination, with a bifid median nerve (MN) and an interconnection of the median with the ulnar nerve (MN-UN). Unilaterally the “reverse” interconnection (MN-UN) was identified. Emphasis was given to the artery’s developmental background. Methods The PMA was identified in an 80-year-old formalin-embalmed male cadaver, derived from a body donation program after a signed informed consent. Results In the right forearm, the PMA of antebrachial type, terminated at the wrist, posterior to the palmar aponeurosis. Two neural communications (-) were identified: the UN-MN deep branch, at the forearm’s upper third, and the MN deep stem-UN palmar cutaneous branch, at the lower third (9.7cm distally to the 1st communication). In the left forearm, the PMA of palmar type, ended in the palm giving off the 3rd and 4th proper palmar digital arteries. An incomplete superficial palmar arch was identified by the PMA, radial and ulnar arteries’ contribution. After MN bifurcation into superficial and deep branches, the deep branches formed a loop, through which coursed the PMA. The MN deep branch communicated with the UN palmar cutaneous branch. Conclusions The PMA should be evaluated, as a causative factor of carpal tunnel syndrome. The modified Allen's test, and the Doppler ultrasound may detect the arterial flow and the angiography may depict the vessel thrombosis in complex cases. PMA could also be a "salvage" vessel for the hand supply, in radial and ulnar artery trauma.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Median artery bilateral persistence in coexistence with a bifid median nerve and a communication with the ulnar nerve and vice-versa

Piagkou

Tsakotos

Triantafyllou

et al. 2023

Preprint

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“…For example, after passing through the anatomical snuff box, the a. radialis can run toward Digits 1 and 2 as the a. princeps pollicis and a. radialis indicis , respectively, instead of forming the arcus palmaris profundus (Latiff et al, 2008; Loukas et al, 2005; Patnaik et al, 2002). In some cases, the a. radialis is absent (Porter & Mellow, 2001; Pretterklieber et al, 2017; Suzuki et al, 1985; Zheng et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Branching patterns of the vascularization and innervation of the primate forelimb

Vanhoof

Wagemans

Leeuwen

et al. 2022

Journal of Morphology

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In this study, we investigate the branching patterns of the vascularization and innervation of the primate forelimb by performing detailed dissections of five unembalmed nonhuman primate specimens belonging to five different species, that is, rhesus macaque (Macaca mulatta), white-handed gibbon (Hylobates lar), Western gorilla (Gorilla gorilla), chimpanzee (Pan troglodytes), and bonobo (Pan paniscus).Results are compared with five embalmed human specimens (Homo sapiens), and anatomical data of previous studies on nonhuman primates are also included to provide a broader comparative framework. The results show that the overall configuration of the forelimb blood vessels and nerves of the different primate species is similar, although some apparent interspecific differences are found. In all nonhuman primates, in contrast to humans, the superficial vena basilica is absent.Moreover, in gorilla, chimpanzee, and bonobo, the superficial vena cephalica is confined to the forearm. In humans, both an arteria interossea anterior and posterior are present, while in nonhuman primates, only an arteria interossea anterior is present, which migrates to the posterior side at the level of the musculus pronator quadratus. For the innervation, the nervus (n.) medianus and n. ulnaris connect in the forearm of the gorilla and macaque. In the gibbon, the brachial plexus shows some differences in the branching pattern at the fasciculus level compared to the other primates. We conclude that the forelimb innervation branching pattern shows some minor differences between the nonhuman primate species, compared to higher plasticity in the vascularization. However, the exact functional implications of these differences still remain unclear. Therefore, more research on a broader range of primate species and sampling more specimens for each taxon are needed.

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“…4,5 Complete absence of radial artery is very rare with only twelve reported cases in the literature; eight of these were of unilateral aplasia and only four cases reported bilateral absence of the artery without any associated vascular or non-vascular malformations. 6,7 This paper presents a case of a female patient with endstage renal disease (ESRD) and bilateral absence of radial arteries that were discovered after AVF failure. The case was a complex of multiple defects that give a probable picture of VACTERL association; which is a sporadic multifactorial association of non-random multisystem birth defects comprising vertebral defects, anal atresia, cardiac defects, tracheo-esophageal abnormalities, renal anomalies and limb defects as the acronym VACTERL implies.…”

Section: Introductionmentioning

confidence: 99%

Difficult vascular access for hemodialysis in congenital bilateral absence of radial artery and probable VACTERL association: a case report

Mahbuba¹,

Kareem²

2022

Anaesth. pain intensive care

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Isolated bilateral absence of radial artery in association with other congenital anomalies, together named VACTERL (vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities) is a very rare phenomenon. We report a patient, known to have VACTERL association, and who presented with ESRD. He was on hemodialysis and had been subjected to multiple failed tries at vascular access due to congenital bilateral absence of radial arteries and other vascular anomalies. This case report highlights hemodialysis options in congenital bilateral absence of radial artery and probable VACTERL association showing superiority of arteriovenous fistula despite its accompanying complications. Key words: VACTERL; Abnormalities, Multiple / classification; Kidney / abnormalities; Limb Deformities, Congenital; Bilateral absent radial artery; Hemodialysis; AV fistula, Failure; AV fistula, Complications Abbreviations: VACTERL - Vertebral defects, Anal atresia, Cardiac defects, Tracheo-esophageal fistula, Renal anomalies, and Limb abnormalities; AVF - Arteriovenous fistula; ESRD - End-stage renal disease; AVG - Arteriovenous graft; CVC - Central venous catheter Citation: Kareem G, Mahbuba W. Difficult vascular access for hemodialysis in congenital bilateral absence of radial artery and probable VACTERL association: a case report. Anaesth. pain intensive care 2022;26(3):559-562. DOI: 10.35975/apic.v26i4.1966 Received: June 05, 2022; Reviewed: June 12, 2022; Accepted: June 17, 2022

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Congenital Bilateral Absence of the Radial Artery: A Very Rare Variation in Humans - Phylogenetic and Ontogenetic Aspects

Cited by 5 publications

References 13 publications

Median artery bilateral persistence in coexistence with a bifid median nerve and a communication with the ulnar nerve and vice-versa

Median artery bilateral persistence in coexistence with a bifid median nerve and a communication with the ulnar nerve and vice-versa

Branching patterns of the vascularization and innervation of the primate forelimb

Difficult vascular access for hemodialysis in congenital bilateral absence of radial artery and probable VACTERL association: a case report

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