Images in vascular medicine

Abstract

Panel B Panel AA 44-year-old man was brought to the emergency department after being struck in the upper right chest by airborne debris while watching an automobile race. The impact resulted in an open fracture of the right clavicle and a right pulmonary contusion but no pneumothorax. Thorough examination in the emergency department revealed a non-palpable right radial artery pulse and a strong, palpable right ulnar artery pulse. The patient had no detectable neurologic deficit and his right hand was warm and well perfused. Right upper extremity angiography was performed to evaluate for possible vascular injury. Arteriography revealed normal subclavian, axillary and brachial arteries proximally. In the forearm (Panel A), there was a normal ulnar artery (black arrow), a diminutive interosseous artery (white arrow), and a congenitally absent right radial artery with no evidence of thrombosis or embolism. Distally, the entire right hand was perfused by only the right ulnar artery (Panel B). The patient's neurovascular status remained stable and he was discharged from the hospital after operative repair of his clavicular fracture.Congenital absence of the radial artery, also known as radial artery aplasia, is a rare anatomic variant with a reported frequency estimated to be 0.1% or less.1 Documentation of absence of the radial artery in the literature is scarce. 2 This variation causes no symptoms and no treatment is required. The angiogram in this case illustrates this uncommon congenital variation causing a diminished distal pulse in this trauma patient.

Bilaterally symmetrical congenital absence of radial artery: a case report

“…In 2001, Cowles [10] found a 44-year-old man with congenital absence of right radial artery from a right upper extremity angiography. He had a normal ulnar artery and a small interosseous artery, and his entire right hand was perfused by only the right ulnar artery.…”