Buch Chirag, Devora Candice M, Johnson Linda Y, Rahimi Omid B, Kar Rekha
Long School of Medicine, University of Texas Health at San Antonio, San Antonio, TX 78229, USA.
Department of Cell Systems and Anatomy, University of Texas Health at San Antonio, San Antonio, TX 78229, USA.
Int J Surg Case Rep. 2019;58:205-207. doi: 10.1016/j.ijscr.2019.04.035. Epub 2019 Apr 30.
The superficial palmar arch (SPA) is a major source of blood supply to much of the hand and is conventionally formed by the anastomosis of the ulnar artery with the superficial branch of the radial artery. The SPA has been classified into complete or incomplete based on the presence or absence of anastomosis between the arteries contributing to the formation of this palmar arch.
Reported here is a unilateral presentation of incomplete superficial palmar arch. The ulnar artery (UA) gave off one proper palmar digital artery, which supplied the ulnar side of the little finger, and two common palmar digital arteries, which supplied the little, ring, and the middle finger. The superficial palmar branch of the radial artery gave off a proper palmar digital artery to the thumb, and two common palmar digital arteries, which supplied the thumb, index, and middle fingers. Apart from the presence of the incomplete SPA, persistent median arteries were also observed bilaterally in this cadaver.
The prevalence of incomplete SPA has been reported to vary between 3.6-54.76%. To the best of our knowledge, this is the first case report describing an incomplete palmar arch and bilateral persistent median artery in a cadaver.
Patients should be screened for the presence of complete or incomplete SPA before harvesting the radial artery either for myocardial revascularization or for radial artery forearm flap to prevent ischemic complications in the hand.
掌浅弓(SPA)是手部大部分区域的主要血液供应来源,传统上由尺动脉与桡动脉浅支吻合形成。根据构成该掌弓的动脉之间有无吻合,掌浅弓可分为完整型或不完整型。
本文报告一例单侧不完整掌浅弓病例。尺动脉(UA)发出一支指掌侧固有动脉,供应小指尺侧,以及两支指掌侧总动脉,供应小指、环指和中指。桡动脉浅支发出一支指掌侧固有动脉至拇指,以及两支指掌侧总动脉,供应拇指、示指和中指。除了存在不完整掌浅弓外,在该尸体双侧还观察到永存正中动脉。
据报道,不完整掌浅弓的发生率在3.6%-54.76%之间。据我们所知,这是第一例描述尸体中不完整掌弓和双侧永存正中动脉的病例报告。
在为心肌血运重建或桡动脉前臂皮瓣采集桡动脉之前,应对患者进行掌浅弓完整或不完整情况的筛查,以预防手部缺血并发症。