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1.
Surg Radiol Anat ; 45(9): 1089-1095, 2023 Sep.
Article de Anglais | MEDLINE | ID: mdl-37452194

RÉSUMÉ

OBJECTIVE: To study the anatomy and biometry of the radial artery and to report the implications of this study for daily practice in Cardiac Surgery. METHOD: Radial arteries from 45 human cadavers (28 males and 17 females, average age 79.2 (92) fixed in 10% formalin were dissected. The proximal and distal internal calibers and lengths of these radial arteries were measured. RESULTS: Our results showed the presence of a single radial artery variation in 2.3% of the entire sample (1.1% of the 90 dissected upper limbs). The distance between the epicondyle and the emergence of the radial artery was 32.4 (6.67) mm in men and 30.7 (9.00) mm in women, with an average of 31.8 (7.58) mm. For the right upper limb, the mean proximal internal caliber of the radial artery was 3.16 (0.56) mm and its mean distal internal caliber was 2.62 (0.66) mm. For the left upper limb, the mean proximal internal caliber of the radial artery was 3.17 (0.59) mm and its mean distal internal caliber was 2.64 (0.68) mm. The mean length of the left radial artery was 197.0 (17) mm. The mean length of the right radial artery was 201.0 (33) mm. CONCLUSION: It is very important to be aware of the possible anatomical variation of the radial artery. Despite its rarity, this knowledge may ensure a better safety and reliability of the harvesting technique for use as a graft.


Sujet(s)
Bras , Artère radiale , Mâle , Humains , Femelle , Sujet âgé , Artère radiale/anatomie et histologie , Reproductibilité des résultats , Bras/anatomie et histologie , Cadavre , Biométrie
2.
Folia Morphol (Warsz) ; 82(4): 948-952, 2023.
Article de Anglais | MEDLINE | ID: mdl-37016782

RÉSUMÉ

The aim of the following study was to present and comprehensively describe a case of a bilateral absence of the deep brachial artery (DBA). Furthermore, its embryology and clinical significance will also be discussed. During routine dissection, a 71-year-old male cadaver with a bilateral abnormality in the DBA and its branches was found. The first branch of the brachial artery (BA) was found to be the radial collateral artery, which passed behind the radial nerve. Furthermore, the middle collateral artery originated distal to the radial collateral artery and gave off first a singular, minor muscular branch and then the superior ulnar collateral artery. Later, the preceding nutrient arteries of the humerus and the deltoid branch consecutively branched off from the middle collateral artery. Subsequently, the middle ulnar collateral artery, the inferior ulnar collateral artery, the deltoid artery, the radial artery, and the ulnar artery branched off from the BA, as adapted in the current knowledge regarding the anatomy of the upper extremity. Furthermore, detailed measurements of the distances between the mentioned arteries were carried out. In the present study, a bilateral absence of the DBA was demonstrated. Meta-analysis focusing on the anatomy of this artery has shown how variable its characteristics are. However, our case report is the first in the literature to present this extremely rare variation. Having adequate knowledge regarding the anatomy of the arteries of the proximal arm is of immense importance when performing orthopaedic and reconstructive surgeries in this area.


Sujet(s)
Bras , Artère brachiale , Mâle , Humains , Sujet âgé , Artère brachiale/anatomie et histologie , Artère ulnaire/anatomie et histologie , Artère radiale/anatomie et histologie , Humérus , Cadavre
3.
Int. j. morphol ; 41(2): 548-554, abr. 2023. ilus
Article de Espagnol | LILACS | ID: biblio-1440318

RÉSUMÉ

Los avances en el área de la salud, con el desarrollo de nuevos procedimientos diagnósticos y quirúrgicos, requieren un conocimiento cada vez más preciso de la anatomía humana. La difusión de la disposición variable de la anatomía resulta primordial no sólo en el campo de la especialización o el postgrado, sino por sobre todo, en el pregrado, desde donde se formarán los especialistas que luego desarrollarán esas nuevas prácticas clínicas y quirúrgicas que requerirán una sólida formación anatómica. Es por esto que la aplicación correcta de técnicas anatómicas en las muestras anatómicas es fundamental para que esta enseñanza en el pregrado pueda desarrollarse de manera eficiente, teniendo la plastinación un rol fundamental en este sentido. El objetivo de este trabajo consistió en dar a conocer el hallazgo de variaciones anatómicas arteriales en los miembros superiores de una muestra humana sometida al proceso de plastinación para fomentar, por un lado, la importancia del conocimiento anatómico en el pregrado, el postgrado y las especialidades, como así también la relevancia de la preservación a largo plazo de material biológico para la difusión continua de la anatomía.


SUMMARY: Advances in the area of health with the development of new diagnostic and surgical procedures require an increasingly precise knowledge of human anatomy. The diffusion of the variable arrangement of anatomy is essential not only in the field of specialization or postgraduate, but above all, in the undergraduate, from where the specialists will be trained who will later develop these new clinical and surgical practices that will require a solid anatomical background. This is why the correct application of anatomical techniques in anatomical samples is essential for this undergraduate teaching to be developed efficiently, plastination having a fundamental role in this regard. The aim of this work was to report the discovery of anatomical variations in the upper limbs of a human sample subjected to the plastination process to promote, on one hand, the importance of anatomical knowledge in undergraduate, postgraduate and specialties, as well as the relevance of long- term preservation of biological material for the continued dissemination of anatomy.


Sujet(s)
Humains , Artère ulnaire/anatomie et histologie , Artère radiale/anatomie et histologie , Membre supérieur/vascularisation , Variation anatomique , Plastination
4.
J Invasive Cardiol ; 34(7): E505-E509, 2022 07.
Article de Anglais | MEDLINE | ID: mdl-35714225

RÉSUMÉ

BACKGROUND: Interventional cardiologists prefer the right radial artery (RA) approach for coronary angiography and interventions, mainly for ergonomic reasons. However, the use of the left RA presents certain advantages, and the snuffbox approach has further potential advantages, including lower probability for RA occlusion, avoidance of direct puncture of the RA (thus maintaining its suitability for use as a graft), as well as easier and faster hemostasis. METHODS: Consecutive patients scheduled for coronary catheterization were included, using the left distal RA (ldRA) in the anatomical snuffbox as the default vascular access site. RESULTS: Out of 2034 consecutive cases, the ldRA was used as initial vascular access in 1977 patients (97.2%). The procedural failure rate was 9.9% (21.9% inability to puncture the artery, 75.0% inability to advance the wire, 3.1% other reasons). There was a sharp decrease in failure rate after about the first 200 cases (20.8% in the first decile vs 8.7% throughout the rest of the caseload; P<.001). No or very weak palpable pulse was the most important predictor of failure (odds ratio, 16.0; 95% confidence interval, 11.2-23.1; P<.001), in addition to older age, small stature, and female gender (although, after adjustment for height, the latter was no longer significant). CONCLUSION: In a large series of consecutive patients scheduled for left heart catheterization, through a period of 12 months, with virtually no exclusions except those few imposed by anatomy or compelling clinical needs, the ldRA arterial access approach was shown to be highly effective, feasible, and safe.


Sujet(s)
Cardiologues , Intervention coronarienne percutanée , Cathétérisme cardiaque , Coronarographie , Femelle , Humains , Ponctions , Artère radiale/anatomie et histologie
5.
Ethiop J Health Sci ; 32(2): 445-452, 2022 Mar.
Article de Anglais | MEDLINE | ID: mdl-35693573

RÉSUMÉ

Background: The anatomy of the radial artery draws great interests among anatomists for its frequent involvement in variations. Equally, these variations have gained significant attention from clinicians because of the preference to use the radial artery for catheterization. The commonest of radial artery variations involve its site of origin. In published literature, data on this variations exist, but the prevalence of such variations in a Kenyan population has hitherto been unknown. Methods: Sixty-two upper limbs from 50 formalin-fixed cadavers were studied during dissection in the Department of Human Anatomy, University of Nairobi. Results: Fifty-four (87.1%) radial arteries arose within the cubital fossa, while eight (12.9%) had a high origin. Out of the eight high arteries, two (3.2%) branched off from the axillary artery, another two (3.2%) were branches of the proximal third of the brachial artery and four (6.5%) arose from the middle third of the brachial artery. The high origin radial arteries were more common on the right upper limbs (5 out of the 8 cases). Both axillary and brachial origins were seen bilaterally. Conclusion: The present study details important variations in the anatomy of the radial artery in a Kenyan population. With the radial artery being utilized during clinical, surgical and radiological interventions so frequently, an increased understanding and anticipation of such topographic variances is paramount.


Sujet(s)
Artère brachiale , Artère radiale , Artère axillaire/anatomie et histologie , Artère brachiale/anatomie et histologie , Cadavre , Humains , Kenya , Artère radiale/anatomie et histologie
6.
Am Surg ; 88(7): 1570-1572, 2022 Jul.
Article de Anglais | MEDLINE | ID: mdl-35337202

RÉSUMÉ

There are variations in anatomy that may alter the vasculature of an individual. This case report demonstrates an abnormal branching pattern of a lacerated ulnar artery and its successful surgical repair. Without proper identification, anatomical variations can negatively impact a trauma patient.


Sujet(s)
Lacérations , Artère ulnaire , Humains , Lacérations/diagnostic , Lacérations/chirurgie , Artère radiale/anatomie et histologie , Artère ulnaire/anatomie et histologie , Artère ulnaire/traumatismes , Artère ulnaire/chirurgie
7.
Folia Morphol (Warsz) ; 81(1): 227-233, 2022.
Article de Anglais | MEDLINE | ID: mdl-33577075

RÉSUMÉ

BACKGROUND: This report presents a series of cases representing variant origin and course of the ulnar artery, namely the superficial ulnar artery (SUA), observed during the review of collection of historical specimens prepared in the 19th century by the prominent Polish anatomist Ludwik Karol Teichmann and his collaborators, exhibited in the Anatomy Museum of Jagiellonian University Medical College. RESULTS: Three distinct variants of the SUA were found on anatomical specimens of the upper limb with arteries injected by using Teichmann's method. In case no. 1, the SUA originated from the brachial artery slightly above the interepicondylar line of the humerus. This aberrant vessel gave off the common interosseous artery in the upper half of the cubital fossa and then ran superficially to the bicipital aponeurosis and over the muscles arising from the medial epicondyle of the humerus. The cases no. 2 and 3 involved two similar variants of the superficial artery in which the common interosseous artery arose from the radial artery. In the unique case no. 4, the SUA arose from the radial artery. CONCLUSIONS: The SUA shows diverse anatomy regarding its topography and blood supply territory. Orthopaedic, hand, and plastic surgeons should be aware of anatomic variations of the SUA both in planning and in conducting surgeries of the upper limb.


Sujet(s)
Main , Artère ulnaire , Artère brachiale/anatomie et histologie , Cadavre , Main/vascularisation , Humains , Artère radiale/anatomie et histologie , Tendons , Artère ulnaire/anatomie et histologie
8.
World Neurosurg ; 155: e588-e591, 2021 11.
Article de Anglais | MEDLINE | ID: mdl-34474160

RÉSUMÉ

BACKGROUND: The radial artery is gaining popularity as a vascular access site for neurointerventional procedures. However, recent analyses of wrist position and radial artery anatomy has suggested that the extended position of the wrist is not always necessary. Therefore, the following cadaveric study was performed to verify these findings. METHODS: Twenty adult cadaveric upper limbs underwent dissection of the radial artery. The radial artery was exposed but left in its anatomical position. With the hand supinated, the wrist was extended to 45 degrees and 90 degrees. Observations were then made of any movement of the artery during these ranges of motion. Next, a tension gauge was attached to the radial artery and any tension on the artery measured during the above noted ranges of motion. RESULTS: During extension of the wrist, none of the radial artery specimens was found to move in any direction. Moreover, an average of only 0.28 N of tension on the artery was found with wrist extension up to 90 degrees. Our cadaveric study found that, contrary to popular belief, extension of the wrist during cannulation of the radial artery does not change the position of the artery nor does it significantly alter the tension on the artery. CONCLUSIONS: These data support several recent clinical studies.


Sujet(s)
Cathétérisme périphérique/méthodes , Artère radiale/anatomie et histologie , Dispositifs d'accès vasculaires , Poignet/anatomie et histologie , Poignet/vascularisation , Sujet âgé , Sujet âgé de 80 ans ou plus , Cadavre , Cathétérisme périphérique/instrumentation , Femelle , Humains , Mâle , Adulte d'âge moyen , Artère radiale/anatomopathologie , Poignet/anatomopathologie
9.
J Clin Neurosci ; 90: 279-283, 2021 Aug.
Article de Anglais | MEDLINE | ID: mdl-34275564

RÉSUMÉ

BACKGROUND: Recently there is a trend for radial first which advocates radial artery access as the first choice to perform diagnostic and interventional neurovascular procedures. Although safer than the conventional common femoral artery access, it is associated with a high rate of radial artery occlusion. Distal radial artery access is recently proposed to avoid this complication. This study aims to assess the feasibility and safety of distal radial artery access across a wide range of interventional neurovascular procedures. MATERIALS AND METHODS: All Interventional neurovascular cases attempted via distal radial artery access from September 2019 till March 2021 were included in the study. Data regarding patient demographics, distal radial artery diameter, access site cannulation, size of the sheath, procedural details including success rate and complications were collected. RESULTS: During the study period, 102 patients underwent 114 procedures via the distal radial artery approach. The mean age of patients was 41.9 ± 15.2 years. Overall procedure success rate via DRA was 94.7% (108/114). 72 diagnostic cerebral angiograms and 36 interventional procedures were successfully completed while six procedures required switching to alternate access. CONCLUSION: Distal radial artery access is a safe and feasible option for diagnostic cerebral angiography and a wide range of neurovascular procedures.


Sujet(s)
Artère radiale/imagerie diagnostique , Radiographie interventionnelle/méthodes , Adulte , Sujet âgé , Angiographie cérébrale/méthodes , Procédures endovasculaires/méthodes , Études de faisabilité , Femelle , Humains , Mâle , Adulte d'âge moyen , Procédures de neurochirurgie/méthodes , Artère radiale/anatomie et histologie , Études rétrospectives , Dispositifs d'accès vasculaires
11.
Turk Kardiyol Dern Ars ; 49(4): 257-265, 2021 06.
Article de Anglais | MEDLINE | ID: mdl-34106059

RÉSUMÉ

OBJECTIVE: Distal transradial access (TRA) has been recently introduced as an alternative access site for coronary angiography (CAG). Both procedures can be performed in cardiology clinics by interventional cardiologists. Although distal TRA is considered to be more difficult as it requires artery puncture and experienced cardiologists, it seems to be more advantageous because of the limited risk of arterial occlusion. In this study, we share our experiences with distal TRA and conventional TRA. METHODS: Seventy patients undergoing CAG via distal TRA and 63 patients via conventional TRA were included in this study. The patients' data were reviewed retrospectively and compared in terms of procedural characteristics and complications. RESULTS: There was no significant difference between the distal TRA group (94.2%) and the conventional TRA group (98.4%) in terms of success rate (p=0.217). In the distal TRA group, the total sheath emplacement time was longer (p<0.001), and hemostasis time was shorter (p<0.001) compared with conventional TRA. Total procedural time and hospitalization period were not statistically different between the groups (p>0.05). Radial spasm and radial occlusion were more common in the conventional TRA group than in the distal TRA group (7.9% vs 1.4% and 3.1% vs 1.4%, respectively), and hematomas were not statistically different between the groups. CONCLUSION: Although distal TRA seems more advantageous in terms of less hemostasis time and less vascular complications, it takes a longer time for sheath insertion and may cause more pain, which may diminish its efficiency. Large-scale studies are needed to address this issue.


Sujet(s)
Syndrome coronarien aigu/imagerie diagnostique , Coronarographie/méthodes , Artère radiale , Sujet âgé , Artériopathies oblitérantes/étiologie , Cathétérisme périphérique/effets indésirables , Cathétérisme périphérique/méthodes , Coronarographie/effets indésirables , Femelle , Hématome/épidémiologie , Hémorragie/épidémiologie , Hémostase chirurgicale , Humains , Mâle , Durée opératoire , Ponctions , Artère radiale/anatomie et histologie , Artère radiale/chirurgie , Études rétrospectives , Facteurs temps
12.
World Neurosurg ; 152: e484-e491, 2021 08.
Article de Anglais | MEDLINE | ID: mdl-34098135

RÉSUMÉ

BACKGROUND: Distal transradial access (dTRA) has several advantages compared with proximal transradial access (pTRA) for cerebral angiography. The learning curve for transitioning from pTRA to dTRA has not been described. METHODS: Retrospective analysis of the first 75 diagnostic cerebral angiograms performed with dTRA by a single operator was performed. Outcomes included time for sheath insertion, sheath to first vessel time, procedure duration, fluoroscopy time, radiation dose, and contrast volume. Their associations with procedure number were evaluated with multivariate linear regressions, segmented linear regression, and locally weighted regression (LOESS). RESULTS: The mean age of patients was 56.1 years and 61.3% were female. Seventy-four of 75 angiograms were successfully completed with dTRA. There were 3 minor and no major complications. After adjusting for covariates, sheath to first vessel time (ß = -0.50, P < 0.001) and procedure duration (ß = -0.26, P = 0.002) were associated with procedure number. Time for sheath insertion, fluoroscopy time, radiation dose, and contrast volume were not associated with procedure number. Segmented linear regression identified break-points of 33 for sheath to first vessel time and 11 for procedure duration, which corresponded to the procedure number after which these outcomes trended down. LOESS models for time to sheath placement, procedure duration, fluoroscopy time, and radiation dose predicted minimum values between procedures 40-50. CONCLUSIONS: Transitioning from pTRA to dTRA for diagnostic cerebral angiography is feasible and safe. The learning curve is overcome between procedures 11 and 33, and further refinement in performance occurs through procedures 40-50.


Sujet(s)
Angiographie cérébrale/méthodes , Courbe d'apprentissage , Artère radiale/anatomie et histologie , Adulte , Sujet âgé , Angiographie cérébrale/effets indésirables , Produits de contraste/administration et posologie , Femelle , Radioscopie , Humains , Mâle , Adulte d'âge moyen , Modèles statistiques , Procédures de neurochirurgie/méthodes , Dose de rayonnement , Études rétrospectives , Résultat thérapeutique , Jeune adulte
13.
Int. j. morphol ; 39(3): 915-919, jun. 2021. ilus
Article de Espagnol | LILACS | ID: biblio-1385392

RÉSUMÉ

RESUMEN: Se presentan 3 casos de variación de origen de la arteria digital palmar propia radial del índice, dos de los cuales tienen su origen en la rama palmar superficial de la arteria radial, no detalladas previamente en la literatura, junto a variaciones vasculares en uno de ellos, mientras que en el tercero, su origen en la arteria digital palmar propia ulnar del pulgar, es fuente de controversia. Esto es discutida en la presente comunicación. Se describen anastomosis vasculares entre la arteria ulnar superficial, la rama palmar superficial de la arteria radial, la primera arteria interósea dorsal y la arteria digital palmar propia radial del índice, como circuitos anastomóticos alternativos.


SUMMARY: We present 3 cases of variation of origin of the index radial proper palmar digital artery, two of which have their origin in the superficial palmar branch of the radial artery, not previously detailed in the literature, together with vascular variations in one of them, while in the third, its origin in the palmar proper ulnar digital artery of thumb, is a source of controversy. This is discussed in this communication. Vascular anastomoses between the superficial ulnar artery, the superficial palmar branch of the radial artery, the first dorsal interosseous artery, and the radial index palmar digital artery are described as alternative anastomotic circuits.


Sujet(s)
Humains , Artère radiale/anatomie et histologie , Variation anatomique , Main/vascularisation
14.
Int. j. morphol ; 39(2): 347-354, abr. 2021. ilus
Article de Espagnol | LILACS | ID: biblio-1385357

RÉSUMÉ

RESUMEN: El objetivo de este trabajo consiste en el análisis de la posición del arco palmar superficial en la palma de la mano, con identificación del origen, forma de disposición, anastomosis presentes y terminación del mismo, proporcionando la experiencia propia y comparándola con los referentes del área, sin llevar adelante una comparación de clasificaciones, sino por el contrario, buscando analizar la información desde un punto de vista clínico-quirúrgico, demostrando la importancia del conocimiento de la anatomía real del arco palmar superficial al momento de abordar la anatomía vascular de la mano en todo tipo de situaciones patológicas.


SUMMARY: The objective of this work consists in the analysis of the position of the superficial palmar arch in the palm of the hand, with identification of the origin, form of disposition, present anastomosis and termination of the same, providing the own experience and comparing it with the referents of the area, without carrying out a comparison of classifications, but on the contrary, seeking to analyze the information from a clinical-surgical point of view, demonstrating the importance of knowledge of the real anatomy of the superficial palmar arch when addressing the vascular anatomy of the hand in all kinds of pathological situations.


Sujet(s)
Humains , Adulte d'âge moyen , Sujet âgé , Sujet âgé de 80 ans ou plus , Artère ulnaire/anatomie et histologie , Artère radiale/anatomie et histologie , Variation anatomique , Main/vascularisation , Cadavre
15.
Emerg Med J ; 38(7): 524-528, 2021 Jul.
Article de Anglais | MEDLINE | ID: mdl-33500267

RÉSUMÉ

BACKGROUND: It is generally recommended to keep the wrist joint mildly dorsiflexed during radial artery catheterisation. However, wrist dorsiflexion might decrease the success rate of radial artery catheterisation with dynamic needle tip positioning technique. Therefore, we assessed the success rates of two groups with or without wrist dorsiflexion by 5 cm wrist elevation in adult patients. METHODS: This randomised controlled clinical trial was performed between March and December 2018 in the First Affiliated Hospital of Shantou University Medical College, China. We recruited 120 adult patients undergoing major surgical procedures and randomly allocated them into two groups: dorsiflexion group (group D) and neutral group (group N). The primary outcome was first-attempt success rates of two groups. Secondary outcomes were overall success rates within 5 min; numbers of insertion and cannulation attempts; overall catheterisation time; duration of localisation, insertion and cannulation; and complication rates of catheterisation. RESULTS: First-attempt success rate was 88.3% in group D and 81.7% in group N (p=0.444). The overall success rate within 5 min was 93.3% in group D compared with 90.0% in group N (p=0.743). Numbers of insertion and cannulation attempts, overall catheterisation time, duration of localisation and insertion, and complication rates did not show a significant difference between the two groups. Cannulation time was longer in group N (35.68 s) than that in group D (26.19 s; p<0.05). CONCLUSION: Wrist dorsiflexion may not be a necessity for ultrasound-guided radial artery catheterisation using dynamic needle tip positioning technique in adult patients. TRIAL REGISTRATION NUMBER: ChiCTR1800015262.


Sujet(s)
Cathétérisme périphérique/normes , Artère radiale/chirurgie , Échographie interventionnelle/statistiques et données numériques , Poignet/anatomie et histologie , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Cathétérisme périphérique/méthodes , Cathétérisme périphérique/statistiques et données numériques , Chine , Femelle , Humains , Mâle , Adulte d'âge moyen , Artère radiale/anatomie et histologie , Artère radiale/physiopathologie , Échographie interventionnelle/méthodes , Poignet/chirurgie
16.
Surg Radiol Anat ; 43(3): 397-403, 2021 Mar.
Article de Anglais | MEDLINE | ID: mdl-33392700

RÉSUMÉ

PURPOSE: Simultaneous lesions of both proper digital arteries of the thumb are common in hand trauma surgery. The purpose of this anatomical study was to determine if the dorsal arterial network could be sufficient to ensure the vascularization of the thumb skin sheath. METHODS: We carried out a cadaveric study on 22 hands. The ulnar and radial proper digital arteries of the thumb were ligated at the base of the first phalanx. Red dye was injected into the radial artery and blue dye into the ulnar artery at the wrist level. Visual evaluation of skin staining and systematic photographs was done at 1, 3 and 10 min after injection of dyes. RESULTS: Staining of the thumb sheath was obtained in 100% of the dissections and complete in 91.91% of cases. Staining originated from mixed radial and ulnar artery origins in 81.82% of cases. It was incomplete in 9.09% of cases with a missing on the dorsoradial edge of the proximal phalanx. In one dissection, the whole hand skin was only stained red, and in another dissection only stained blue. CONCLUSION: The dorsal vascular network ensures the substitution of the skin vascularization in more than 90% of cases when ligating the proper digital arteries of the thumb. A clinical impression of good skin vascularization after injury of both proper digital arteries might lead the surgeon not to perform systematic revascularization, but the risk of variable damages of adjacent tissues due to an interruption of one major arterial system requires a palmar arterial anastomosis whenever possible.


Sujet(s)
Artère radiale/traumatismes , Pouce/vascularisation , Artère ulnaire/traumatismes , Sujet âgé , Sujet âgé de 80 ans ou plus , Anastomose chirurgicale/méthodes , Cadavre , Femelle , Blessures de la main/chirurgie , Humains , Mâle , Adulte d'âge moyen , Artère radiale/anatomie et histologie , Artère radiale/chirurgie , Artère ulnaire/anatomie et histologie , Artère ulnaire/chirurgie
17.
Anat Sci Int ; 96(2): 310-314, 2021 Mar.
Article de Anglais | MEDLINE | ID: mdl-32909194

RÉSUMÉ

Although arterial variations in the upper limb are usually found during anatomical dissections and clinical practice, multiple arterial variations associated with nervous variations along the limb is rare and clinically relevant. This paper described a combined anatomical variation involving the neurovasculature in the upper limb. A left upper limb dissection of a male cadaver with approximately 50-60 years of age, fixed in 10% formalin, was performed. During the dissection was observed, the brachial artery ending in the middle third of the arm in three branches: a nutritional branch for the biceps brachii muscle, a "lateral brachial artery" and a "medial brachial artery", which became, after unusual paths crossing over the cubital fossa, the ulnar artery and the radial artery, respectively. Radial and ulnar artery demonstrated several unusual anastomotic branches, respectively, and an anastomotic arch around the biceps brachii muscle tendon. Such combined anatomical variation is unique and relevant for clinical and surgical practice.


Sujet(s)
Artère brachiale/anatomie et histologie , Artère radiale/anatomie et histologie , Artère ulnaire/anatomie et histologie , Membre supérieur/vascularisation , Cadavre , Humains , Mâle , Adulte d'âge moyen
18.
Ther Apher Dial ; 25(3): 273-281, 2021 Jun.
Article de Anglais | MEDLINE | ID: mdl-32749076

RÉSUMÉ

An arteriovenous fistula (AVF) remains the best choice of vascular access (VA) for hemodialysis (HD). The aim of the study was to determine the factors associated with the achievement of adequate blood flow (BF) of AVFs at the 4th week after creation. Created AVFs in 63 patients with chronic kidney disease (CKD) stage 4/5 and CKD stage 5 on hemodialysis (CKD5D) were analyzed in a prospective study. Doppler ultrasound (DUS) was used for measuring the diameter of the radial artery, the brachial artery and the cephalic vein before AVF creation. The BF of AVF was calculated by DUS at the 4th week after creation and adequate BF was defined as ≥ 600 mL/min. The average age of patients was 61.31 ± 12.9 years. An adequate BF of AVF at the 4th week after creation was achieved in 43.54% of patients. The BF of AVF measured in male patients was significantly higher compared to the BF of AVF obtained in females (576.03 mL/min vs 375.12 mL/min, P = 0.004). The diameter of the blood vessels with achieved adequate BF was significantly larger compared to the diameter of the blood vessels without adequate BF (radial artery: 2.45 mm vs 2.03 mm, P = 0.000; brachial artery: 4.78 mm vs 4.06 mm, P = 0.001 and cephalic vein: 3.12 mm vs 2.83 mm P = 0.018). The gender and the diameter of the blood vessels before AVF creation were significantly associated with achievement of adequate BF of AVF at the 4th week of creation.


Sujet(s)
Anastomose chirurgicale artérioveineuse/méthodes , Hémodynamique/physiologie , Période préopératoire , Dialyse rénale/instrumentation , Degré de perméabilité vasculaire/physiologie , Sujet âgé , Vitesse du flux sanguin , Artère brachiale/anatomie et histologie , Artère brachiale/physiologie , Femelle , Humains , Mâle , Adulte d'âge moyen , Études prospectives , Artère radiale/anatomie et histologie , Artère radiale/physiologie , Facteurs sexuels , Échographie/méthodes
19.
Radiol Med ; 126(4): 630-635, 2021 Apr.
Article de Anglais | MEDLINE | ID: mdl-33155168

RÉSUMÉ

PURPOSE: To describe the variability of the radial artery (RA) diameters at 2 levels, proximal (pRA), within 2 cm to the styloid process, and distal (dRA) at the snuff box, both eligible accesses for percutaneous approach, and to correlate these diameters with population features. METHODS: A total of 700 patients (377 females, 323 males) have been enrolled from July 2018 to March 2019. The diameters of left and right RA were measured using ultrasound (US) examination. Diameters of pRA and dRA were compared between different sex and CRF (tabagism, hypertension, hyperlipidemia, BMI > 30, diabetes) using multivariate analysis and unpaired t test; the feasibility of radial access was evaluated considering a diameter ≥ of 2 mm as a cut-off or a vessel/sheath ratio >1. The time needed to perform each assessment of the four vessels was recorded. RESULTS: The average proximal diameter of pRA was 2.58 mm (sd = 0.58 mm). The caliber of the dRA resulted 19.5% lower than the proximal one, with an average diameter of 1.99 mm (sd = 0.47 mm). On unpaired t test, a significant difference was reported for two of the parameters taken into account: sex and a BMI > 30. CONCLUSION: Our results show that 88% of patients have an estimated radial artery caliber suitable for pTRA at US examination. Males and patients with BMI > 30 show a higher mean pRA and dRA; thus, they could be the ideal candidates for radial access.


Sujet(s)
Procédures endovasculaires/méthodes , Artère radiale/anatomie et histologie , Artère radiale/imagerie diagnostique , Échographie-doppler couleur , Adulte , Femelle , Humains , Mâle , Artère radiale/chirurgie , Facteurs sexuels
20.
Int. j. morphol ; 38(4): 853-856, Aug. 2020. graf
Article de Espagnol | LILACS | ID: biblio-1124865

RÉSUMÉ

La arteria recurrente radial nace en el extremo proximal de la arteria radial y desde ahí asciende oblicuamente para anastomosarse con la arteria colateral radial, entregando en ese trayecto una serie de ramas para los músculos cercanos. Dicha arteria junto con sus ramas fueron descritas (por su importancia en abordajes quirúrgicos) por Arnold K. Henry como "the radial leash". Actualmente en clínica se utiliza el nombre "leash of Henry" para referirse a una o más ramas musculares de la arteria recurrente radial, sobretodo cuando cuando se encuentran en relación con el ramo profundo del nervio radial, pudiendo llegar a causar compresiones de dicho nervio en algunos casos. Se realizó una descripción de caso de una leash of Henry atípica, encontrada en una muestra cadavérica del laboratorio de anatomía de la Universidad Católica del Maule, de sexo masculino y nacionalidad chilena. La arteria encontrada corresponde a la rama de mayor calibre de la arteria recurrente radial, que se dirige directamente al músculo extensor de los dedos, dibujando un trayecto horizontal y cruzando por anterior al ramo profundo del nervio radial. Esta hallazgo difere a lo descrito por Henry y otros autores más recientes, y por lo tanto aporta información potencialmente útil a la hora de realizar procedimientos quirúrgicos que requieran un abordaje posterior o lateral de la cabeza del radio, como también descompresiones del nervio radial en esta zona.


The radial recurrent artery originates at the proximal end of the radial artery and from there ascends obliquely to anastomosing with the radial collateral artery. It gives off several branches for nearby muscles on its path. This artery along with its branches were described (due to its importance in surgical approaches) by Arnold K. Henry as "the radial leash". Currently, in clinical terms, the name "Leash of Henry" is used to refer to one or more muscular branches of the radial recurrent artery, especially when they are in relation to the deep branch of the radial nerve, and may cause compression of the nerve in some cases. A case description of an atypical Leash of Henry was found, found in a Chilean, male cadaveric sample of the anatomy laboratory, Universidad Católica del Maule. The artery corresponds to the branch of greater caliber of the recurrent radial artery, which goes directly to the extensor digitorum muscle. It draws a horizontal path and crosses the deep branch of the radial nerve anteriorly. This finding differs from what was described by Henry and other more recent authors. Therefore, this is potentially useful information when performing surgical procedures that require a posterior or lateral approach to the radius head, as well as radial nerve decompressions in this area.


Sujet(s)
Humains , Mâle , Adulte d'âge moyen , Nerf radial/anatomie et histologie , Artère radiale/anatomie et histologie , Coude/anatomie et histologie , Cadavre , Coude/innervation , Coude/vascularisation , Variation anatomique
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