It is fairly common to find anatomic variations and anomalies in the arterial pattern of the upper extremities.However,a complete absence of the distal ulnar artery bilaterally is extremely rare.During preoperative as...It is fairly common to find anatomic variations and anomalies in the arterial pattern of the upper extremities.However,a complete absence of the distal ulnar artery bilaterally is extremely rare.During preoperative assessment for a radial forearm free flap,we accidentally discovered bilateral distal ulnar artery agenesis.In this article,the clinical implications of this variation are discussed,along with a review of the literature.展开更多
Congenital aneurysms of the palm are uncommon in the pediatric population compared to aneurysms in adults.A seven-month-old boy presented with a true aneurysm of the ulnar artery with reconstruction with surgical exci...Congenital aneurysms of the palm are uncommon in the pediatric population compared to aneurysms in adults.A seven-month-old boy presented with a true aneurysm of the ulnar artery with reconstruction with surgical excision and end-to-end microvasculer anastomosis using a superficial vein of the dorsal foot.To our knowledge,there have been only 15 reports of congenital aneurysms of the palm.展开更多
Cubital tunnel syndrome is often accompanied by paresthesia in ulnar nerve sites and hand muscle atrophy. When muscle weakness occurs, or after failure of more conservative treatments, anterior transposition is used. ...Cubital tunnel syndrome is often accompanied by paresthesia in ulnar nerve sites and hand muscle atrophy. When muscle weakness occurs, or after failure of more conservative treatments, anterior transposition is used. In the present study, the ulnar nerve and its blood vessels were examined in the elbows of 18 adult cadavers, and the external diameter of the nutrient vessels of the ulnar nerve at the point of origin, the distances between the origin of the vessels and the medial epicondyle of the humerus, and the length of the vessels accompanying the ulnar nerve in the superior ulnar collateral artery, the inferior ulnar collateral artery, and the posterior ulnar recurrent artery were measured. Anterior transposition of the vascularized ulnar nerve was per- formed to treat cubital tunnel syndrome. The most appropriate distance that the vascularized ulnar nerve can be moved to the subcutaneous tissue under tension-free conditions was 1.8 ± 0.6 cm （1.1-2.5 cm）, which can be used as a reference value during the treatment of cubital tunnel syndrome with anterior transposition of the vascularized ulnar nerve.展开更多
Background More and more percutaneous coronary intervention were done from radial artery approach. But the great limitation of radial artery approach and main failure cause of transradial coronary intervention is smal...Background More and more percutaneous coronary intervention were done from radial artery approach. But the great limitation of radial artery approach and main failure cause of transradial coronary intervention is smaller size and more variations of a radial artery approach. The aim of the study is to explore the features and variations of a radial artery approach in southern Chinese populations and their clinical significance in percutaneous coronary intervention. Methods A total of 1400 patients who underwent scheduled first time transradial coronary angiography between July 2007 and September 2010 were enrolled. Radial arteriography was performed in all patients to detect the anatomical variations of this vessel. All patients＇ radial and ulnar artery inner diameters were measured using a computer assisted quantification method. A detailed patient history was recorded. Multivariate Logistic regression analysis was performed to evaluate the predictive value of variables （including age, gender, ethnicity, height, weight, body mass index, smoking, diabetes, hypertension and dyslipidemia） in arterial tortuosities and variations of this vessel. Results In southern Chinese populations, there were no significant differences in the diameters of the forearm arteries： the mean radial artery inner diameter was （3.04±0.43） mm in ethnic Han Chinese and （3.05±0.42） mm in ethnic Zhuang Chinese, P 〉0.05）, the mean ulnar artery inner diameter was （3.03±0.38） mm in Han Chinese and （3.05±0.36） mm in Zhuang Chinese, P 〉0.05）. It was estimated that the inner diameter of the radial artery was not smaller than a 6F Cordis sheath in 86.1% of male patients and in 57.0% of female patients, and not smaller than a 7F Cordis sheath in 59.3% of male patients and 24.9% of female patients. The factors found to positively affect the size of the radial artery were sex （bj=0.309, P 〈0.01）, weight （bj=0.103, P 〈0.01 ）, and diabetes mellitus （bj=-0.088, P 〈0.01） was found to negatively affect radial artery size. Arterial tortuosities occurred in 12.1% of patients and arterial variations in 4.1%. The incidence of tortuosities and variations included radial artery tortuosity （3.6%）, high origin of radial artery （1.7%）, radial artery loop （0.6%）, double radial artery （0.1%）, brachial artery tortuosity （0.4%）, double brachial artery （0.1%）, subclavian artery tortuosity （5.4%）, small subclavian artery （0.4%）, right retro-esophageal subclavian artery （0.6%）, brachiocephalic trunk tortuosity （2.8%）, small brachiocephalic artery （0.1%）, and brachiocephalic artery anomaly （0.4%）. For people in Guangxi province, tortuosities of the subclavian artery and radial artery are the most common among the vascular tortuosities of the radial artery approach. The overall rate of transradial procedural success was 96.1%. Procedural failure was more common in patients with anomalous radial artery approach than in patients with normal radial artery approach （22.8% vs. 1.8%, P=0.000）. According to multivariate Logistic regression analysis, age （OR=2.695, 95% CI 2.232-3.253, P=0.000）, female gender （OR=5.127, 95% CI 3.000-8.762, P=0.000）, height （OR=0.612, 95% CI 0.465-0.807, P=0.000）, body mass index （OR=2.377, 95% CI 1.834-3.082, P=0.000）, hypertension （OR=1.668, 95% CI 1.132-2,458, P=0.010）, hyperlipidemia （OR=1.273, 95% CI 1.425-2.049, P=0.034） and smoking （OR=5.750, 95% CI 3.636-9.093, P=0.000）, were independently associated with arterial tortuosities of the radial artery approach. Female gender was independently associated with arterial variations of the radial artery approach （OR=3.613, 95% CI 3.208-7.826, P=0.000）. Conclusions The diameters of the radial and ulnar arteries between the Han people and the Zhuang people in southern Chinese populations are similar. In a transradial operation, the most southern Chinese populations, the use of a 6F sheath and guiding catheter is safe, and using a 7F sheath and guiding catheter is feasible in some selected patients. Radial arterial tortuosities and variations in southern Chinese populations are relatively common and are a significant cause of the failure of transradial coronary procedure. Old age, female gender, short stature, high body mass index,hypertension, hyperlipidemia and smoking, were independently associated with an increased risk of arterial tortuosity. In addition, female gender was an independent predictor of arterial variations.展开更多
Traumatic injuries to the thumb resulting in segmental loss of a digital artery are not uncommon.To bridge the gap and repair a transacted digital artery,the superficial palmar arch or the radial digital artery of the...Traumatic injuries to the thumb resulting in segmental loss of a digital artery are not uncommon.To bridge the gap and repair a transacted digital artery,the superficial palmar arch or the radial digital artery of the index finger can be used to reconstruct the ulnar digital artery of thumb for revascularization.Revascularization following segmental loss resulting from a crushed ulnar digital artery of the thumb can be performed based on the superficial palmar arch or the radial digital artery of the index finger,avoiding anastomosis at two sites and hence providing better results.The digital vein from the index finger can also be used to enhance the venous return of the injured thumb.However,because of known variability in the palmar arch,intraoperative verification is needed to ensure the safe transfer of the arch or the radial digital artery of the index finger.The aim of this article is to discuss the possibilities for thumb revascularization,using a case report in which the injured thumb was revascularized with a superficial palmar arch.展开更多
文摘It is fairly common to find anatomic variations and anomalies in the arterial pattern of the upper extremities.However,a complete absence of the distal ulnar artery bilaterally is extremely rare.During preoperative assessment for a radial forearm free flap,we accidentally discovered bilateral distal ulnar artery agenesis.In this article,the clinical implications of this variation are discussed,along with a review of the literature.
文摘Congenital aneurysms of the palm are uncommon in the pediatric population compared to aneurysms in adults.A seven-month-old boy presented with a true aneurysm of the ulnar artery with reconstruction with surgical excision and end-to-end microvasculer anastomosis using a superficial vein of the dorsal foot.To our knowledge,there have been only 15 reports of congenital aneurysms of the palm.
基金supported by the Hunan Provincial Science and Technology Research Project Foundation for Colleges and Universities in China,No.12A119Construct Program of the Key Discipline in Hunan Province,China
文摘Cubital tunnel syndrome is often accompanied by paresthesia in ulnar nerve sites and hand muscle atrophy. When muscle weakness occurs, or after failure of more conservative treatments, anterior transposition is used. In the present study, the ulnar nerve and its blood vessels were examined in the elbows of 18 adult cadavers, and the external diameter of the nutrient vessels of the ulnar nerve at the point of origin, the distances between the origin of the vessels and the medial epicondyle of the humerus, and the length of the vessels accompanying the ulnar nerve in the superior ulnar collateral artery, the inferior ulnar collateral artery, and the posterior ulnar recurrent artery were measured. Anterior transposition of the vascularized ulnar nerve was per- formed to treat cubital tunnel syndrome. The most appropriate distance that the vascularized ulnar nerve can be moved to the subcutaneous tissue under tension-free conditions was 1.8 ± 0.6 cm （1.1-2.5 cm）, which can be used as a reference value during the treatment of cubital tunnel syndrome with anterior transposition of the vascularized ulnar nerve.
文摘Background More and more percutaneous coronary intervention were done from radial artery approach. But the great limitation of radial artery approach and main failure cause of transradial coronary intervention is smaller size and more variations of a radial artery approach. The aim of the study is to explore the features and variations of a radial artery approach in southern Chinese populations and their clinical significance in percutaneous coronary intervention. Methods A total of 1400 patients who underwent scheduled first time transradial coronary angiography between July 2007 and September 2010 were enrolled. Radial arteriography was performed in all patients to detect the anatomical variations of this vessel. All patients＇ radial and ulnar artery inner diameters were measured using a computer assisted quantification method. A detailed patient history was recorded. Multivariate Logistic regression analysis was performed to evaluate the predictive value of variables （including age, gender, ethnicity, height, weight, body mass index, smoking, diabetes, hypertension and dyslipidemia） in arterial tortuosities and variations of this vessel. Results In southern Chinese populations, there were no significant differences in the diameters of the forearm arteries： the mean radial artery inner diameter was （3.04±0.43） mm in ethnic Han Chinese and （3.05±0.42） mm in ethnic Zhuang Chinese, P 〉0.05）, the mean ulnar artery inner diameter was （3.03±0.38） mm in Han Chinese and （3.05±0.36） mm in Zhuang Chinese, P 〉0.05）. It was estimated that the inner diameter of the radial artery was not smaller than a 6F Cordis sheath in 86.1% of male patients and in 57.0% of female patients, and not smaller than a 7F Cordis sheath in 59.3% of male patients and 24.9% of female patients. The factors found to positively affect the size of the radial artery were sex （bj=0.309, P 〈0.01）, weight （bj=0.103, P 〈0.01 ）, and diabetes mellitus （bj=-0.088, P 〈0.01） was found to negatively affect radial artery size. Arterial tortuosities occurred in 12.1% of patients and arterial variations in 4.1%. The incidence of tortuosities and variations included radial artery tortuosity （3.6%）, high origin of radial artery （1.7%）, radial artery loop （0.6%）, double radial artery （0.1%）, brachial artery tortuosity （0.4%）, double brachial artery （0.1%）, subclavian artery tortuosity （5.4%）, small subclavian artery （0.4%）, right retro-esophageal subclavian artery （0.6%）, brachiocephalic trunk tortuosity （2.8%）, small brachiocephalic artery （0.1%）, and brachiocephalic artery anomaly （0.4%）. For people in Guangxi province, tortuosities of the subclavian artery and radial artery are the most common among the vascular tortuosities of the radial artery approach. The overall rate of transradial procedural success was 96.1%. Procedural failure was more common in patients with anomalous radial artery approach than in patients with normal radial artery approach （22.8% vs. 1.8%, P=0.000）. According to multivariate Logistic regression analysis, age （OR=2.695, 95% CI 2.232-3.253, P=0.000）, female gender （OR=5.127, 95% CI 3.000-8.762, P=0.000）, height （OR=0.612, 95% CI 0.465-0.807, P=0.000）, body mass index （OR=2.377, 95% CI 1.834-3.082, P=0.000）, hypertension （OR=1.668, 95% CI 1.132-2,458, P=0.010）, hyperlipidemia （OR=1.273, 95% CI 1.425-2.049, P=0.034） and smoking （OR=5.750, 95% CI 3.636-9.093, P=0.000）, were independently associated with arterial tortuosities of the radial artery approach. Female gender was independently associated with arterial variations of the radial artery approach （OR=3.613, 95% CI 3.208-7.826, P=0.000）. Conclusions The diameters of the radial and ulnar arteries between the Han people and the Zhuang people in southern Chinese populations are similar. In a transradial operation, the most southern Chinese populations, the use of a 6F sheath and guiding catheter is safe, and using a 7F sheath and guiding catheter is feasible in some selected patients. Radial arterial tortuosities and variations in southern Chinese populations are relatively common and are a significant cause of the failure of transradial coronary procedure. Old age, female gender, short stature, high body mass index,hypertension, hyperlipidemia and smoking, were independently associated with an increased risk of arterial tortuosity. In addition, female gender was an independent predictor of arterial variations.
文摘Traumatic injuries to the thumb resulting in segmental loss of a digital artery are not uncommon.To bridge the gap and repair a transacted digital artery,the superficial palmar arch or the radial digital artery of the index finger can be used to reconstruct the ulnar digital artery of thumb for revascularization.Revascularization following segmental loss resulting from a crushed ulnar digital artery of the thumb can be performed based on the superficial palmar arch or the radial digital artery of the index finger,avoiding anastomosis at two sites and hence providing better results.The digital vein from the index finger can also be used to enhance the venous return of the injured thumb.However,because of known variability in the palmar arch,intraoperative verification is needed to ensure the safe transfer of the arch or the radial digital artery of the index finger.The aim of this article is to discuss the possibilities for thumb revascularization,using a case report in which the injured thumb was revascularized with a superficial palmar arch.
