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Evaluation of anatomy and variations of superficial palmar arch and upper extremity arteries with CT angiography

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Abstract

Aim

To evaluate the abnormalities and variations of the arterial system of upper extremities and superficial palmar arch with computed tomography angiography and to guide the clinician during this procedure.

Methods

A total of 156 upper extremities of 78 cases were retrospectively analyzed using computed tomography angiography. The study was approved by the local ethics committee of the hospital. From the analysis of the computed tomography angiography images, the following information was recorded; the diameters and abnormalities of radial, ulnar and brachial arteries in both upper extremities, the presence of atherosclerotic changes or stenosis in these arteries, whether the superficial palmar arch was complete or incomplete, and arterial dominance. Also, the computed tomography angiography classification of superficial palmar arch distribution and anatomic configuration was performed.

Results

The mean baseline diameters of the radial, ulnar and brachial arteries of the cases were; 2.8 ± 0.6, 2.5 ± 0.7, and 4.7 ± 0.6 mm, respectively. A complete superficial palmar arch was observed in 69.2 % of the right hands and 70.5 % of the left hands. For the superficial palmar arches on the right side, the radial artery was dominant in two and the ulnar artery was dominant in 47 with the remaining showing codominance. On the left side, the radial artery was dominant in one hand, with the ulnar artery being dominant in 49 cases, and in 28 cases, there was codominance. In the superficial palmar arch classification, four of the arches (A–D) were defined as complete and the remaining three (E–G) as incomplete.

Conclusion

The current study clarified different variations in palmar circulation and forearm arteries to aid the surgeon during trans-radial or trans-ulnar catheterization, hemodialysis, or coronary artery bypass grafting.

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Acknowledgments

The authors gratefully acknowledge the contributions of Associate Professor Ugur Toprak (UT), who performed the second measurements for the assessment of inter-observer variability, and Professor Mehmet Birhan Yilmaz (MBY), who conducted statistical analyses using the MedCalc software.

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Authors and Affiliations

  1. Department of Radiology, Diskapi Yildirim Beyazit Research and Training Hospital, TR-06100, Ankara, Turkey

    Hatice Kaplanoglu

  2. Faculty of Medicine, Department of Cardiology, Heart Center Hospital, Cumhuriyet University, Sivas, Turkey

    Osman Beton

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  1. Hatice Kaplanoglu
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  2. Osman Beton
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Correspondence to Hatice Kaplanoglu.

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Kaplanoglu, H., Beton, O. Evaluation of anatomy and variations of superficial palmar arch and upper extremity arteries with CT angiography. Surg Radiol Anat 39, 419–426 (2017). https://doi.org/10.1007/s00276-016-1750-6

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  • DOI: https://doi.org/10.1007/s00276-016-1750-6

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