alexa Surgical implications of variations in hand collateral circulation: anatomy revisited.
Anesthesiology

Anesthesiology

Journal of Anesthesia & Clinical Research

Author(s): Ruengsakulrach P, Eizenberg N, Fahrer C, Fahrer M, Buxton BF

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Abstract OBJECTIVES: One of the risks associated with harvesting the radial artery is hand ischemia. Accordingly, this study investigated the variations of the hand collateral circulation. METHODS: Fifty hands of cadavers were examined. Variations of the palmar arches were recorded. A classic superficial palmar arch was defined as direct continuity between the ulnar artery and the superficial palmar branch of the radial artery. A classic complete deep palmar arch was defined as direct continuity between the radial artery and the deep branch of the ulnar artery. RESULTS: A classic superficial palmar arch was found in 10\% (5/50) of hands, and a classic complete deep palmar arch was found in 90\% (45/50) of hands. The superficial palmar branch of the ulnar artery supplied blood to all fingers in 66\% (33/50) of hands. Although the superficial palmar branch of the ulnar artery was continuous with the radial artery in only 34\% (17/50) of hands (including the classic type of superficial palmar arch), every hand had at least one major branch connecting the radial and ulnar arteries. CONCLUSIONS: Variations in the terminations of the radial and ulnar arteries are common. Although the classic type of superficial palmar arch occurs relatively infrequently, there is always a significant anastomosis between the radial and the ulnar artery in the hand. This anatomic study confirms the presence of a collateral supply in the hand. In the absence of vascular disease, harvesting the radial artery should be regarded as a safe procedure. This article was published in J Thorac Cardiovasc Surg and referenced in Journal of Anesthesia & Clinical Research

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