Persistent median artery carpal tunnel syndrome: a case series and literature review

Nowicki, Jake; Cameron, Alexander M.; Griffin, Philip; Lam, Quoc Tai Khoa; Marshall, Nicholas

doi:10.34239/ajops.v2i1.71

Cited by 3 publications

(7 citation statements)

References 30 publications

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“…18,20,25 Thrombosis of the PMA is the most common abnormality leading to CTS. [26][27][28] An aneurysm and calcification of the PMA have also been reported causes of CTS. 28 Thrombosis is postulated to result from direct trauma or a repetitive overload.…”

Section: Persistent Median Artery Thrombosismentioning

confidence: 99%

“…[26][27][28] An aneurysm and calcification of the PMA have also been reported causes of CTS. 28 Thrombosis is postulated to result from direct trauma or a repetitive overload. Pregnancy and hormonal contraceptive pills are also reported risk factors for PMA thrombosis.…”

Section: Persistent Median Artery Thrombosismentioning

confidence: 99%

“…26,28 Carpal tunnel syndromeassociated PMA thrombosis is likely related to mechanical stress or ischemia of the MN. [26][27][28] Ultrasound allows for detection and an accurate assessment of the PMA. 26,29 In PMA thrombosis, the US findings include an enlarged artery, located close to a normal or bifid MN, filled with an intraluminal hypoechoic thrombus ( Figure 2).…”

Section: Persistent Median Artery Thrombosismentioning

confidence: 99%

“…A palmar‐type PMA travels close to the MN inside the CT and is frequently associated with a bifid MN 18,20,25 . Thrombosis of the PMA is the most common abnormality leading to CTS 26‐28 . An aneurysm and calcification of the PMA have also been reported causes of CTS 28 .…”

Section: Congenital Causesmentioning

confidence: 99%

“…Thrombosis is postulated to result from direct trauma or a repetitive overload. Pregnancy and hormonal contraceptive pills are also reported risk factors for PMA thrombosis 26,28 . Carpal tunnel syndrome–associated PMA thrombosis is likely related to mechanical stress or ischemia of the MN 26‐28 .…”

Section: Congenital Causesmentioning

confidence: 99%

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Ultrasound Findings in Less Frequent Causes of Carpal Tunnel Syndrome

Bianchi

Hoffman

Tamborrini

et al. 2020

J of Ultrasound Medicine

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The most common etiology of carpal tunnel syndrome (CTS) is idiopathic. However, secondary causes of CTS should be considered when symptoms are unilateral, or electrodiagnostic studies are discrepant with the clinical presentation. Imaging of the carpal tunnel should be performed when secondary causes of CTS are suspected. An ultrasound evaluation of the carpal tunnel can assess for pathologic changes of the median nerve, detect secondary causes of CTS, and aid in surgical planning.

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Section: Persistent Median Artery Thrombosismentioning

confidence: 99%

Section: Persistent Median Artery Thrombosismentioning

confidence: 99%

Section: Persistent Median Artery Thrombosismentioning

confidence: 99%

Section: Congenital Causesmentioning

confidence: 99%

Section: Congenital Causesmentioning

confidence: 99%

See 3 more Smart Citations

Ultrasound Findings in Less Frequent Causes of Carpal Tunnel Syndrome

Bianchi

Hoffman

Tamborrini

et al. 2020

J of Ultrasound Medicine

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Persistent median artery and communicating branch related to the superficial palmar arch

Simić,

Bumbaširević,

Jović

et al. 2024

Sci Rep

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Microvascular surgery, plastic and reconstructive hand surgery, and coronary artery bypass surgery call for a microanatomical study of the branching pattern of the superficial palmar arch (SPA). For the anatomical analysis, we used a group of 20 dissected human hands injected with 4% formaldehyde solution and a 10% mixture of melted gelatin and India ink. The morphometric study was performed on 40 human hands of adult persons injected with methyl-methacrylate fluid into the ulnar and radial arteries simultaneously and afterwards corroded in 40% KOH solution for the preparation of corrosion cast specimens. The mean diameter of the SPA, between the second and third common palmar digital arteries, was 1.86 ± 0.08 mm. We identified the persistent median artery (PMA) in 5% of hands. We distinguished the three main groups of the SPAs according to variations in morphology and branching of the arch: Type 1, the long SPA; Type 2, the middle length SPA; and Type 3, the short SPA found in 27.5% of specimens. The communicating branch (CB), a vessel interconnecting the SPA to the closest branch of the radial artery, is classified into two different morphological groups. The third type of incomplete short arterial arch is the most important of the three groups of SPAs. That short SPA is potentially inadequate for restoring circulation after occlusion or radial artery harvesting for coronary artery bypass.

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Acute carpal tunnel syndrome from thrombosed persistent median artery in a patient with congenitally absent radial artery

2023

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Objectives Thrombosis of the persistent median artery (PMA) is a rare cause of acute carpal tunnel syndrome (ACTS). Existence of a congenitally absent radial artery in this setting has not been described in the literature Methods Computed Tomography Angiography (CTA) and doppler screening were used in pre surgical planning. Open surgical decompression was achieved through the release of the flexor retinaculum in the left hand. A regimen of 100 mg of Aspirin for 3 months time was initiated to encourage clot resolution and recanalization of the thrombosed artery. Results The PMA was found to be abnormally large measuring approximately 4 mm in diameter. Visible clotting off of the PMA in keeping with the doppler scans with maintenance of distal flow and was left intact with the hopes that it would recanalize over time. At the 3-month post-op review the antiplatelet therapy was ceased and the patient was symptom free, demonstrated no signs of ischaemia in the hand, and had returned to full functionality and physical activity Conclusions Although infrequently encountered, the knowledge of the anatomical variations of the forearm and hand together with doppler screening and CTA is essential to the surgical management of ACTS.

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Persistent median artery carpal tunnel syndrome: a case series and literature review

Cited by 3 publications

References 30 publications

Ultrasound Findings in Less Frequent Causes of Carpal Tunnel Syndrome

Ultrasound Findings in Less Frequent Causes of Carpal Tunnel Syndrome

Persistent median artery and communicating branch related to the superficial palmar arch

Acute carpal tunnel syndrome from thrombosed persistent median artery in a patient with congenitally absent radial artery

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