Year 2023,
Volume: 36 Issue: 2, 223 - 229, 31.05.2023
Rasim Hamutoglu
,
Sukru Turan Pestemalcı
Mehmet Yıldırım
References
- [1] Gokhroo R, Bisht D, Gupta S, Kishor K, Ranwa B. Palmar
arch anatomy: ajmer working group classification. Vascular
2016;24:31-6. doi: 10.1177/170.853.8115576428.
- [2] Joshi SB, Vatsalaswamy P, Bahetee BH. Variation in formation
of superficial palmar arches with clinical implications. J Clin
Diagn Res 2016;8:6-9. doi: 10.7860/JCDR/2014/7078.4252
- [3] Saha A, Lal N, Pal S. The superficial palmar arch: A
morphological study. Int J Anat Res 2019;7:6918-23. doi:
10.16965/ijar.2019.256
- [4] Suman U, Jayanthi KS. A study of complete superficial palmar
arches formed entirely by ulnar artery. J Anat Soc India,
2011;60:199-201. doi.org/10.1016/S0003-2778(11)80026-2
- [5] Zarzecki MP, Popieluszko P, Zayachkowski A, Pękala PA,
Henry BM, Tomaszewski KA. The surgical anatomy of the
superficial and deep palmar arches: a Meta-analysis. J Plast
Reconstr Aesthet Surg 2018;71:1577-92. doi: 10.1016/j.
bjps.2018.08.014
- [6] Yıldırım M, Resimli Sistematik Anatomi: Istanbul: Nobel Tıp
Kitabevleri, 2013:363.
- [7] Singh S, Lazarus L, De Gama BZ, Satyapal KS. An anatomical
investigation of the superficial and deep palmar arches.
Folia Morphol (Warsz) 2017;76:219-25. doi: 10.5603/
FM.a2016.0050
- [8] Patil J, Kumar N, Aithal AP, Swamy RS, Rao KGM. An
eccentric anatomical variation of palmar vascular pattern:
Report of surgical challenging vascular variation. J Med Sci
2016:36:240-2. doi: 10.4103/1011-4564.196372
- [9] McLean KM, Sacks JM, Kuo YR, Wollstein R, Rubin JP,
Andrew Lee WP. Anatomical landmarks to the superficial and
deep palmar arches. Plast Reconstr Surg 2008;121:181-5. doi:
10.1097/01.prs.000.029.3863.45614.f9
- [10] Bilge O, Pinar Y, Özer MA, Gövsa FA. Morphometric study
on the superficial palmar arch of the hand. Surg Radiol Anat
2006;28:343-50. doi: 10.1007/s00276.006.0109-9
- [11] Coleman S, Anson J. Arterial pattern in handbased upon a
study of 650 specimens. Surg Gynaecol Obstet 1961;113:409-
24.
- [12] Anitha T, Kalbande S, Dombe D, Asha K, Jayasree N.
Variations in the formation of superficial palmar arch and
its clinical significance in hand surgeries. Int J Biol Med Res
2011;2:543-6.
- [13] Rodriguez-Niedenführ M, Vazguez T, Parkin IG, Sanudo
JR. Arterial patterns of the human upper limb: update of
anatomical variations and embryological development. Eur J
Anat 2003;7:21-8.
- [14] Rauch D, Fischer C, Achenbach S, Klose KJ, Wagner
HJ. Angiography detection of closed palmar arcs. Rofo
1999;171:207-10.
- [15] Loukas M, Holdman D, Holdman S. Anatomical variations of
superficial and deep palmar arches. Folia Morphol 2005;64:78-
83.
- [16] Patnaik VVG, Kalsey G, Singla-Rajan K. Palmar arterial
arches-A morphological study. J Anat Soc India 2002;51:187-
93.
- [17] van Leeuwen MAH, Hollander MR, van der Heijden DJ, et
al. The ACRA anatomy study (assessment of disability after
coronary procedures using radial access): a comprehensive
anatomic and functional assessment of the vasculature of the
hand and relation to outcome after transradial catheterization.
Circ Cardiovasc Interv 2017;10:e005753. doi: 10.1161/
CIRCINTERVENTIONS.117.005753
- [18] Gellman H, Botte MJ, Shankwiler J, Gelberman R. Arterial
patterns of the deep and superficial palmar arches. Clin
Orthop Relat Res 2001;383:41-6.
- [19] Ghuran AV, Dixon G, Holmberg S, de Belder A, Hildick-Smith
D. Transradial coronary intervention without pre-screening
for a dual palmar blood supply. Int J Cardiol 2006;121:320-2.
doi: 10.1016/j.ijcard.2006.11.009
- [20] Hollander MR, van Leeuwen MA, van der Heijden DJ, et al.
Non-invasive assessment of the collateral circulation in the
hand: validation of the nexfin system and relation to clinical
outcome after transradial catheterisation. EuroIntervention
2017;12:1773-81. doi: 10.4244/EIJ-D-16-00337.
- [21] Tanzilli G, Truscelli G, Barillà F, et al. Evaluation of hand
circulation with cardiowaves photoplethysmograph device
during allen test in healthy volunteers. Eur Rev Med Pharmacol
Sci 2015;19:3006-11.
- [22] Bigler MR, Buffle E, Siontis GCM, et al. Invasive assessment
of the human arterial palmar arch and forearm collateral
function during transradial access. Circ Cardiovasc Interv
2019;12:e007744.
- [23] Dhar P, Lall K. An atypical anatomical variation of palmar
vascular pattern. Singapore Med J 2008;49:245.
- [24] Bilge O, Özer MA, Pınar Y, Gövsa F. Deep palmar arch in Man.
Türkiye Klinikleri J Med Sc 2009;29:816-20.
- [25] Olave E, Prates JC. Deep palmar arch pattern in Brazilian
individuals. Surg Radiol Anat 1999;21:267-71.
- [26] Bini N, Leclercq C. Anatomical study of the deep branch of
the ulnar nerve and application to selective neurectomy in the
treatment of spasticity of the first web space. Surg Radiol Anat
2020;42:253-8. doi: 10.1007/s00276.019.02380-y
- [27] Gil YC, Shin KJ, Lee SH, Koh KS, Song WC. Anatomy of
the deep branch of the ulnar nerve. J Hand Surg (European
Volume) 2016;41:1-5. doi: 10.1177/175.319.3415622188
- [28] Wynter S, Dissabandara L. A comprehensive review of
motor innervation of the hand: variations and clinical
significance. Surg Radiol Anat 2018;40:259-69. doi: 10.1007/
s00276.017.1898-8
- [29] Sulaiman S, Soames R, Lamb C. Ulnar nerve cutaneous
distribution in the palm: application to surgery of the hand.
Clin Anat 2015;28:1022-8. doi: 10.1002/ca.22626
- [30] Aragão JA, da Silva ACF, Anunciação CB, Reis FP. Median
artery of the forearm in human fetuses in northeastern Brazil:
anatomical study and review of the literature. Anat Sci Int
2017;92:107-11. doi: 10.1007/s12565.015.0322-x
Formation and branching patterns of deep palmar arch
Year 2023,
Volume: 36 Issue: 2, 223 - 229, 31.05.2023
Rasim Hamutoglu
,
Sukru Turan Pestemalcı
Mehmet Yıldırım
Abstract
Objective: The present study is to document and provide information about both normal and variable morphology of the deep palmar
arch (DPA) in adult human cadavers by the dissection method.
Materials and Methods: We examined 12 upper extremities (6 cadavers). After the classification of the vascular patterns of DPA and
its branches, measurements of the vessel diameters were carried out using a digital compass.
Results: Deep palmar arch was found as a completed arch (100%) in all cases. The anastomosis between the distal deep palmar branch
of the ulnar artery (DPBUA) and the terminal branch of the radial artery (RA) was the most common type in our study. The incidence
of the DPA was reported as a complete arch ranging from 54.9% to 100%. Palmar metacarpal arteries (MPAs) originating from the
DPA were divided into four branches (25%) in three cases and three branches (75%) in nine cases. The mean diameter of the MPAs at
the point of origin at the DPA was between 0.3 mm and 0.6 mm.
Conclusion: A comprehensive understanding of the DPA branching diameters in the hand will facilitate surgical and radiological
approaches and contribute to a constantly expanding knowledge base in literature.
References
- [1] Gokhroo R, Bisht D, Gupta S, Kishor K, Ranwa B. Palmar
arch anatomy: ajmer working group classification. Vascular
2016;24:31-6. doi: 10.1177/170.853.8115576428.
- [2] Joshi SB, Vatsalaswamy P, Bahetee BH. Variation in formation
of superficial palmar arches with clinical implications. J Clin
Diagn Res 2016;8:6-9. doi: 10.7860/JCDR/2014/7078.4252
- [3] Saha A, Lal N, Pal S. The superficial palmar arch: A
morphological study. Int J Anat Res 2019;7:6918-23. doi:
10.16965/ijar.2019.256
- [4] Suman U, Jayanthi KS. A study of complete superficial palmar
arches formed entirely by ulnar artery. J Anat Soc India,
2011;60:199-201. doi.org/10.1016/S0003-2778(11)80026-2
- [5] Zarzecki MP, Popieluszko P, Zayachkowski A, Pękala PA,
Henry BM, Tomaszewski KA. The surgical anatomy of the
superficial and deep palmar arches: a Meta-analysis. J Plast
Reconstr Aesthet Surg 2018;71:1577-92. doi: 10.1016/j.
bjps.2018.08.014
- [6] Yıldırım M, Resimli Sistematik Anatomi: Istanbul: Nobel Tıp
Kitabevleri, 2013:363.
- [7] Singh S, Lazarus L, De Gama BZ, Satyapal KS. An anatomical
investigation of the superficial and deep palmar arches.
Folia Morphol (Warsz) 2017;76:219-25. doi: 10.5603/
FM.a2016.0050
- [8] Patil J, Kumar N, Aithal AP, Swamy RS, Rao KGM. An
eccentric anatomical variation of palmar vascular pattern:
Report of surgical challenging vascular variation. J Med Sci
2016:36:240-2. doi: 10.4103/1011-4564.196372
- [9] McLean KM, Sacks JM, Kuo YR, Wollstein R, Rubin JP,
Andrew Lee WP. Anatomical landmarks to the superficial and
deep palmar arches. Plast Reconstr Surg 2008;121:181-5. doi:
10.1097/01.prs.000.029.3863.45614.f9
- [10] Bilge O, Pinar Y, Özer MA, Gövsa FA. Morphometric study
on the superficial palmar arch of the hand. Surg Radiol Anat
2006;28:343-50. doi: 10.1007/s00276.006.0109-9
- [11] Coleman S, Anson J. Arterial pattern in handbased upon a
study of 650 specimens. Surg Gynaecol Obstet 1961;113:409-
24.
- [12] Anitha T, Kalbande S, Dombe D, Asha K, Jayasree N.
Variations in the formation of superficial palmar arch and
its clinical significance in hand surgeries. Int J Biol Med Res
2011;2:543-6.
- [13] Rodriguez-Niedenführ M, Vazguez T, Parkin IG, Sanudo
JR. Arterial patterns of the human upper limb: update of
anatomical variations and embryological development. Eur J
Anat 2003;7:21-8.
- [14] Rauch D, Fischer C, Achenbach S, Klose KJ, Wagner
HJ. Angiography detection of closed palmar arcs. Rofo
1999;171:207-10.
- [15] Loukas M, Holdman D, Holdman S. Anatomical variations of
superficial and deep palmar arches. Folia Morphol 2005;64:78-
83.
- [16] Patnaik VVG, Kalsey G, Singla-Rajan K. Palmar arterial
arches-A morphological study. J Anat Soc India 2002;51:187-
93.
- [17] van Leeuwen MAH, Hollander MR, van der Heijden DJ, et
al. The ACRA anatomy study (assessment of disability after
coronary procedures using radial access): a comprehensive
anatomic and functional assessment of the vasculature of the
hand and relation to outcome after transradial catheterization.
Circ Cardiovasc Interv 2017;10:e005753. doi: 10.1161/
CIRCINTERVENTIONS.117.005753
- [18] Gellman H, Botte MJ, Shankwiler J, Gelberman R. Arterial
patterns of the deep and superficial palmar arches. Clin
Orthop Relat Res 2001;383:41-6.
- [19] Ghuran AV, Dixon G, Holmberg S, de Belder A, Hildick-Smith
D. Transradial coronary intervention without pre-screening
for a dual palmar blood supply. Int J Cardiol 2006;121:320-2.
doi: 10.1016/j.ijcard.2006.11.009
- [20] Hollander MR, van Leeuwen MA, van der Heijden DJ, et al.
Non-invasive assessment of the collateral circulation in the
hand: validation of the nexfin system and relation to clinical
outcome after transradial catheterisation. EuroIntervention
2017;12:1773-81. doi: 10.4244/EIJ-D-16-00337.
- [21] Tanzilli G, Truscelli G, Barillà F, et al. Evaluation of hand
circulation with cardiowaves photoplethysmograph device
during allen test in healthy volunteers. Eur Rev Med Pharmacol
Sci 2015;19:3006-11.
- [22] Bigler MR, Buffle E, Siontis GCM, et al. Invasive assessment
of the human arterial palmar arch and forearm collateral
function during transradial access. Circ Cardiovasc Interv
2019;12:e007744.
- [23] Dhar P, Lall K. An atypical anatomical variation of palmar
vascular pattern. Singapore Med J 2008;49:245.
- [24] Bilge O, Özer MA, Pınar Y, Gövsa F. Deep palmar arch in Man.
Türkiye Klinikleri J Med Sc 2009;29:816-20.
- [25] Olave E, Prates JC. Deep palmar arch pattern in Brazilian
individuals. Surg Radiol Anat 1999;21:267-71.
- [26] Bini N, Leclercq C. Anatomical study of the deep branch of
the ulnar nerve and application to selective neurectomy in the
treatment of spasticity of the first web space. Surg Radiol Anat
2020;42:253-8. doi: 10.1007/s00276.019.02380-y
- [27] Gil YC, Shin KJ, Lee SH, Koh KS, Song WC. Anatomy of
the deep branch of the ulnar nerve. J Hand Surg (European
Volume) 2016;41:1-5. doi: 10.1177/175.319.3415622188
- [28] Wynter S, Dissabandara L. A comprehensive review of
motor innervation of the hand: variations and clinical
significance. Surg Radiol Anat 2018;40:259-69. doi: 10.1007/
s00276.017.1898-8
- [29] Sulaiman S, Soames R, Lamb C. Ulnar nerve cutaneous
distribution in the palm: application to surgery of the hand.
Clin Anat 2015;28:1022-8. doi: 10.1002/ca.22626
- [30] Aragão JA, da Silva ACF, Anunciação CB, Reis FP. Median
artery of the forearm in human fetuses in northeastern Brazil:
anatomical study and review of the literature. Anat Sci Int
2017;92:107-11. doi: 10.1007/s12565.015.0322-x