Kaplanoglu Hatice, Beton Osman
Department of Radiology, Diskapi Yildirim Beyazit Research and Training Hospital, TR-06100, Ankara, Turkey.
Faculty of Medicine, Department of Cardiology, Heart Center Hospital, Cumhuriyet University, Sivas, Turkey.
Surg Radiol Anat. 2017 Apr;39(4):419-426. doi: 10.1007/s00276-016-1750-6. Epub 2016 Sep 19.
To evaluate the abnormalities and variations of the arterial system of upper extremities and superficial palmar arch with computed tomography angiography and to guide the clinician during this procedure.
A total of 156 upper extremities of 78 cases were retrospectively analyzed using computed tomography angiography. The study was approved by the local ethics committee of the hospital. From the analysis of the computed tomography angiography images, the following information was recorded; the diameters and abnormalities of radial, ulnar and brachial arteries in both upper extremities, the presence of atherosclerotic changes or stenosis in these arteries, whether the superficial palmar arch was complete or incomplete, and arterial dominance. Also, the computed tomography angiography classification of superficial palmar arch distribution and anatomic configuration was performed.
The mean baseline diameters of the radial, ulnar and brachial arteries of the cases were; 2.8 ± 0.6, 2.5 ± 0.7, and 4.7 ± 0.6 mm, respectively. A complete superficial palmar arch was observed in 69.2 % of the right hands and 70.5 % of the left hands. For the superficial palmar arches on the right side, the radial artery was dominant in two and the ulnar artery was dominant in 47 with the remaining showing codominance. On the left side, the radial artery was dominant in one hand, with the ulnar artery being dominant in 49 cases, and in 28 cases, there was codominance. In the superficial palmar arch classification, four of the arches (A-D) were defined as complete and the remaining three (E-G) as incomplete.
The current study clarified different variations in palmar circulation and forearm arteries to aid the surgeon during trans-radial or trans-ulnar catheterization, hemodialysis, or coronary artery bypass grafting.
利用计算机断层血管造影评估上肢动脉系统和掌浅弓的异常与变异情况，并在此过程中为临床医生提供指导。
对78例患者的156条上肢进行回顾性计算机断层血管造影分析。该研究经医院当地伦理委员会批准。通过对计算机断层血管造影图像的分析，记录以下信息：双侧上肢桡动脉、尺动脉和肱动脉的直径及异常情况，这些动脉中是否存在动脉粥样硬化改变或狭窄，掌浅弓是否完整，以及动脉优势情况。此外，还对掌浅弓的分布和解剖结构进行了计算机断层血管造影分类。
病例的桡动脉、尺动脉和肱动脉的平均基线直径分别为：2.8±0.6、2.5±0.7和4.7±0.6毫米。右手掌浅弓完整的占69.2%，左手掌浅弓完整的占70.5%。右侧掌浅弓中，桡动脉为主的有2例，尺动脉为主的有47例，其余为共优势。左侧，桡动脉为主的有1例，尺动脉为主的有49例，28例为共优势。在掌浅弓分类中，四个弓（A - D）被定义为完整，其余三个（E - G）为不完整。
本研究阐明了掌部循环和前臂动脉的不同变异情况，有助于外科医生在经桡动脉或经尺动脉插管、血液透析或冠状动脉旁路移植术中进行操作。
