A Unique Case of Vascular Variations in the Upper Limbs: A Brachioradial Artery and Bilateral Persistent Median Arteries With Incomplete Superficial Palmar Arches.

Numerous vascular variations were observed in the upper limbs of a 109-year-old female donor to the Gift Body Program of Saint Louis University School of Medicine. Variations in the right upper limb included the presence of a brachioradial artery (BRA), persistent median artery (PMA), and an ulnar-dominant incomplete type B superficial palmar arch (SPA). In the left upper limb, the brachial artery bifurcated normally into the ulnar artery (UA) and radial artery (RA). However, a more developed palmar type of PMA was observed, replacing much of the palmar circulation typically supplied by the superficial palmar branch of the RA, which existed only as a small branch anastomosing with the PMA to form a rare arcus medianoradialis-type SPA. Both PMAs arose from their respective UAs distal to the origin of the common interosseous arteries. The left PMA pierced the median nerve (MN) as it descended the forearm. The extent of these variations together presents a unique case of vascularity in the upper limbs. Knowledge of these variations is pertinent to MN compression pathologies as well as procedures involving the upper limb.