Evaluation of distal radial artery cross-sectional internal diameter in pediatric patients using ultrasound.

In this study, we measure the radial artery internal diameter (RAID) in children up to 4 years of age before and after the induction of anesthesia. A B-mode portable color Doppler ultrasound was used to measure the RAID. Three sets of measurements were taken for each child before and after the induction of anesthesia and with the wrist in the neutral and dorsiflexed positions. The reliability of the mean value of the RAID in the three sets in 24 patients was established. There were discrepancies between the RAID and the proposed catheter size in some individuals, which may not only render placement difficult but also have potential for arterial injury. There are good reasons to measure the RAID in small children prior to insertion of an intra-arterial catheter.

Case report of a new variant of double incomplete superficial palmar arch.

A rare, unique and previously non-described form of duplicated incomplete superficial palmar arch is reported in the right hand of a male cadaver. The two incomplete arches were formed from the continuation of two terminal palmar branches of the ulnar artery in the distal third of forearm that were connected by a small transverse artery superficial to the flexor retinaculum. Both arches had no contribution from the radial artery. The palmar digital branches from the lateral arch supplied the lateral two-and-a-half fingers, while those from the medial arch supplied the medial two-and-a-half fingers. The thumb and index had additional blood supply from the princeps pollicis and radialis indicis branches of radial artery. The deep palmar arch was entirely formed by the radial artery with no contribution from the ulnar artery. Previous reports on various patterns of superficial palmar arch are highlighted, and the anatomical and clinical importance of the new pattern are discussed.