Persistent median artery in the hand: A report with a brief review of the literature

Abstract

We encountered a persistent median artery in the forearms and hands bilaterally in a 78-year-old Japanese male cadaver during dissection practice at Wakayama Medical University. The brachial arteries divided into the ulnar and radial arteries. The ulnar artery gave off the median and posterior interosseous arteries at the same point, although the anterior interosseous artery was not found. The median artery ran along the median nerve and bifurcated in the hand. In the superficial layer of the palm, one branch of the median artery ran to the ulnar side of the thumb, whereas the other passed to the second interdigital space. The ulnar artery reached the third and fourth interdigital spaces and the ulnar side of the little finger, and showed no anastomosis with the median artery in the superficial layer of the palm. The radial artery did not give off the superficial palmar branch. Therefore, the formation of the superficial palmar arch was incomplete. In the deep layer of the palm, the radial artery formed the deep palmar arch with the deep palmar branch of the ulnar artery and gave off the princeps pollicis artery. In the dorsum of hand, the radial artery passed over the first dorsal interosseous muscle to the index finger and communicated with the palmar pollical artery from the median artery in the first interosseous space. The present study reports an unusual variation of the persistent median artery in the hand and briefly reviews the literature about the median artery.

Persistent median artery: Cadaveric study and review of the literature

“…In the latter pattern, the artery continues either as the 2nd common palmar digital artery or divides into the 1st two common palmar digital arteries (Coleman and Anson, 1961;Loukas et al, 2005Claassen et al, 2008Natsis et al, 2009). However, the radialmedian pattern of incomplete SPA has also been reported (Sanudo et al, 1994;Tsuruo et al, 2006;Varley et al, 2008;Nayak et al, 2010). The various patterns of PMA contribution to SPA are shown in Figure 1 based on the above-mentioned studies.…”

Bilateral Triad of Persistent Median Artery, a Bifid Median Nerve and High Origin of its Palmar Cutaneous Branch: A Case Report and Clinical Implications

“…Both the left and right PCB (15 cm and 18 cm respectively) in our report were much longer than this average. Tsuruo et al (2007) encountered PMA bilaterally in the forearms and hands in a 78 year old Japanese male cadaver, but there was no B. This image shows a centrally placed PMA between the 2 heads of the bifid median nerve in the right forearm .…”

Persistent Median Artery in a Pediatric Trauma Patient: Case Report

“…[1][2][3][4][5] There are 2 described types based on location and termination: (1) The antebrachial type represents incomplete regression and terminates before the wrist; and (2) the palmar type represents persistence of the embryologic pattern and terminates in the hand. 2 There are also well-described variances in the artery's contribution to the vascular supply of the hand.…”

“…[1][2][3][4][5] Such variation perhaps is related to a number of factors including racial difference among populations or developmental difference between adults and neonates. Vascular supply to the upper limb begins with the development of the axial artery on day 28 of embryological development.…”