scholarly journals Trauma to arteries of the forearm

1994 ◽  
Vol 112 (1) ◽  
pp. 485-488 ◽  
Author(s):  
Nelson Wolosker ◽  
Paulo Celso Motta Guimarães ◽  
Alvaro Gaudëncio ◽  
Sérgio Kuzniec ◽  
Marcel Scheinman ◽  
...  
Keyword(s):  
Radial Artery ◽  
Postoperative Period ◽  
Soft Tissues ◽  
Severe Infection ◽  
Ulnar Artery ◽  
Multiple Organ ◽  
Iatrogenic Trauma ◽  
Arterial Trauma ◽  
Interosseous Artery ◽  
Allen Test

Trauma to arteries of the forearm corresponds to 20% of total arterial trauma. The authors analyzed 24 patients with non iatrogenic trauma of the forearm arteries, cared for from January 1987 to December 1990. All patients were male, trauma by penetrating instrument was the most frequent, with 21 cases (87.5%), absence of pulses was the most frequent clinical manifestation (62.5%), fifteen patients did not present ischemic manifestations (54.2%) and half of the patients did not exhibit neurological symptoms. Injury to only one artery was found in 11 cases, five of them in the radial artery (20.8%), five in the ulnar artery (20.8%) and one in the interosseous artery (4.2%). Concurrent injury to the radial and ulnar arteries was found in 13 cases (54.1%). Regarding nervous impairment, injury to the radial nerve was found in four cases (16.6%) and of the median and ulnar nerves, one case in each (4.1%). All patients with concurrent injury to the ulnar and radial arteries (13) were submitted to arterial restoration. The 11 patients with injury to a sole artery of the forearm were managed as follows: ligature of the interosseous artery in one case, ligature of the radial artery in four cases, raphe of the radial artery in one case, ligature of the ulnar artery in three cases, restoration of the ulnar artery using a segment of the v. saphena in the two cases in which the Allen test had been positive. One patient died in the immediate postoperative period as a result of multiple organ failure due to polytraumatism. Preservation of the member was attained in 23 patients (95.8%) and the sole amputation, was due to extensive traumatism of the soft tissues with severe infection and systemic impairment.

scholarly journals Variations in the branching pattern of brachial, ulnar and radial arteries

2015 ◽  
Vol 04 (02) ◽  
pp. 107-109
Author(s):  
Ashwini Mutalik ◽  
Chandrashekhar Hanji ◽  
Sanjeev I Kolagi ◽  
GB Rairam
Keyword(s):  
Clinical Significance ◽  
Radial Artery ◽  
Undergraduate Students ◽  
Brachial Artery ◽  
Ulnar Artery ◽  
Vascular Anomalies ◽  
Branching Pattern ◽  
Medical College ◽  
Collateral Arteries ◽  
Interosseous Artery

AbstractDuring routine dissection of a cadaver alloted to the undergraduate students in the department of anatomy in SN Medical College, Bagalkot, the authors found multiple variations in the branching pattern of brachial, ulnar and radial arteries. There was high division of brachial artery into ulnar and radial arteries. The profunda brachii originated from brachial artery as usual while superior and inferior ulnar collateral arteries originated from ulnar artery. The radial artery gave origin to common interosseous artery which further divided into anterior and posterior interosseous arteries. All the three arteries i.e. brachial, ulnar and radial were considered as superficial arteries as they were superficial throughout the course. These observations of vascular anomalies are of clinical significance to vascular and plastic surgeons.

The Allen Test — an Investigation of its Accuracy by Fluorescein Angiography

1987 ◽  
Vol 12 (1) ◽  
pp. 82-85
Author(s):  
A. D. McGREGOR
Keyword(s):  
Fluorescein Angiography ◽  
Radial Artery ◽  
Ulnar Artery ◽  
Thenar Eminence ◽  
Clinical Value ◽  
Allen Test

Six consecutive patients whose clinical Allen test suggested a non-patent radial artery have been investigated by intra-arterial fluorescein angiography. Cannulation of the radial artery and injection of fluorescein typically perfused only the thumb and thenar eminence. Occlusion of the ulnar artery, leaving the radial artery as the dominant supply, resulted in fluorescein perfusion of the entire hand. It is concluded that the Allen test is of no clinical value.

scholarly journals Multiple arterial anomalies in upper limb

1970 ◽  
Vol 7 (3) ◽  
pp. 293-297 ◽  
Author(s):  
P Baral ◽  
P Vijayabhaskar ◽  
S Roy ◽  
S Kumar ◽  
S Ghimire ◽  
...  
Keyword(s):  
Radial Artery ◽  
Upper Limb ◽  
Axillary Artery ◽  
Ulnar Artery ◽  
Common Trunk ◽  
Palmar Arch ◽  
Thoracoacromial Artery ◽  
The Third ◽  
Flexor Muscles ◽  
Interosseous Artery

An isolated neurovascular variation is common but multiple vascular anomalies on same upper limb is a very rare case. We observed an unusual variations in right upper limb during routine dissection of a Nepali cadaver. The variations were observed in Axilla, Forearm and Palm. In axilla, first part of axillary artery did not give any branch, the second part of axillary artery gave off only two branches - (a) thoracoacromial artery and (b) a large common trunk which later gave off lateral thoracic, thoracodorsal, subscapular, posterior circumflex scapular and then continued as posterior circumfl ex humeral artery. The third part of axillary artery gave off only anterior circumflex humeral artery. In forearm, the ulnar artery runs downward superficial to flexor muscles. Here, radial artery gave off common interosseous artery. In palm radial artery did not give any contribution to superficial palmar arch which is solely formed by the continuation of ulnar artery. This type of anomalies are very rare and is not reported in Nepalese cadaver at all. These anomalies are described in detail and their clinical relevance is highlighted. Key words: Axillary artery; Brachial artery; Radial artery; Ulnar artery; Palmar arch; Variations DOI: 10.3126/kumj.v7i3.2740 Kathmandu University Medical Journal (2009) Vol.7, No.3 Issue 27, 293-297

Can Ulnar Artery Velocity Changes Be Used as a Preoperative Screening Tool for Radial Artery Grafting in Coronary Artery Bypass?

2003 ◽  
Vol 17 (3) ◽  
pp. 253-259 ◽  
Author(s):  
V.V. Sullivan ◽  
C. Higgenbotham ◽  
C.J. Shanley ◽  
J. Fowler ◽  
R.M. Lampman ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Radial Artery ◽  
Screening Tool ◽  
Artery Bypass ◽  
Ulnar Artery ◽  
Preoperative Screening ◽  
Velocity Changes

Common ground, different path: Ulnar artery access for interventional neurovascular procedures

2021 ◽  
pp. 159101992110402
Author(s):  
Muhammad U. Manzoor ◽  
Ibrahim A. Almulhim ◽  
Abdullah A. Alrashed ◽  
Abdulrahman Y. Alturki ◽  
Fatimah A. Alghabban ◽  
...  
Keyword(s):  
Radial Artery ◽  
Interventional Procedures ◽  
Common Ground ◽  
Interventional Neuroradiology ◽  
Ulnar Artery ◽  
Patient Comfort ◽  
Access Site Complication ◽  
Patient Demographics ◽  
Wide Range ◽  
Feasible Option

Background Recently, radial artery access has gained popularity for interventional neurovascular procedures due to patient comfort and fewer complications. However, there are instances where the radial artery approach is not feasible. In such cases, trans-ulnar artery access (TUA) can offer an alternate route. There is limited data regarding neuro-interventional procedures performed via this approach. This study aims to evaluate the feasibility and safety of trans-ulnar approach for a wide range of interventional neurovascular procedures. Materials and methods The data for all patients who underwent ulnar artery access for diagnostic or interventional neuroradiology procedures was retrospectively collected between September 2020 and March 2021. Patient demographics, procedural details, procedure success, and complications were recorded. Results During the study period, 23 patients underwent 24 trans-ulnar approach procedures. The mean age of patients was 50.1 ± 14.2 years. Fourteen diagnostic cerebral angiograms and ten interventional procedures were performed. All procedures were successfully completed via trans-ulnar approach without a switch to alternate access. No major access site complication was observed. Conclusion Ulnar artery access is a safe and feasible option for neurovascular procedures. It can be effectively utilized for diagnostic cerebral angiography and a wide range of interventional procedures.

Remodeling of ipsilateral ulnar artery after radial artery harvesting for coronary artery bypass graft

2021 ◽  
Vol 99 (2) ◽  
pp. 231-236
Author(s):  
Melchior L. Lima ◽  
Héber S.M. Silva ◽  
Lourival N. Lougon ◽  
Fanilda S. Barros ◽  
Walter J. Gomes
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Radial Artery ◽  
Ultrasound Examination ◽  
Color Doppler ◽  
Artery Bypass ◽  
Ulnar Artery ◽  
Intima Media Thickness ◽  
Diabetic Patients ◽  
Media Thickness

There are controversies in the literature on the blood supply to the forearm after surgical removal of the radial artery in coronary artery bypass grafting (CABG). The objective was to investigate the arterial remodeling of the ulnar artery after the removal of the radial artery in myocardial revascularization by means of ultrasound examination with color Doppler in the pre- and post-operative periods. This paper describes an observational prospective study of the remodeling of the left brachial and ulnar arteries (donor arm) in 103 right-handed non-consecutive adult patients undergoing CABG with removal of the ipsilateral radial artery using the color Doppler ultrasound examination. In the ulnar artery, a significant increase (P < 0.05) was seen in the following measurements: lumen diameter by 13%, lumen area by 26%, peak systolic flow by 40%, and average flow by 46%. Intima-media thickness measured in the ulnar artery did not show a statistically significant difference (P = 0.22), except in diabetic patients (P = 0.007). We conclude that the ulnar artery undergoes positive physiological remodeling, adapting to the new requirements of chronic increase in flow after the ipsilateral removal of the radial artery to serve as a graft in CABG. There was no evidence of increased intima-media thickness, except in diabetic patients.

scholarly journals A Randomized Trial Comparing Short versus Prolonged Hemostasis with Rescue Recanalization by Ipsilateral Ulnar Artery Compression: Impact on Radial Artery Occlusion—The RESCUE-RAO Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Dmitrii V. Ognerubov ◽  
Alexander Sedaghat ◽  
Sergey I. Provatorov ◽  
Andrey S. Tereshchenko ◽  
Olivier F. Bertrand ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Randomized Trial ◽  
Hospital Discharge ◽  
Radial Artery ◽  
Ulnar Artery ◽  
Artery Occlusion ◽  
Puncture Site ◽  
Coronary Procedures ◽  
Baseline Characteristics ◽  
Radial Artery Occlusion

Background. Despite the enormous benefits of radial access, this route is associated with a risk of radial artery occlusion (RAO). Objective. We compared the incidence of RAO in patients undergoing transradial coronary angiography and intervention after short versus prolonged hemostasis protocol. Also we assessed the efficacy of rescue 1-hour ipsilateral ulnar artery compression if RAO was observed after hemostasis. Material and Methods. Patients referred for elective transradial coronary procedures were eligible. After 6 F radial sheath removal, patients were randomized to short (3 hours) (n = 495) or prolonged (8 hours) (n = 503) hemostasis and a simple bandage was placed over the puncture site. After hemostasis was completed, oximetry plethysmography was used to assess the patency of the radial artery. Results. One thousand patients were randomized. Baseline characteristics were similar between both groups with average age 61.4 ± 9.4 years (71% male) and PCI performed on half of the patients. The RAO rate immediately after hemostasis was 3.2% in the short hemostasis group and 10.1% in the prolonged group ( p < 0.001 ). Rescue recanalization was successful only in the short group in 56.2% (11/19); at hospital discharge, RAO rates were 1.4% in the short group and 10.1% in the prolonged group ( p < 0.001 ). Conclusion. Shorter hemostasis was associated with significantly less RAO compared to prolonged hemostasis. Rescue radial artery recanalization was effective in > 50%, but only in the short hemostasis group.

P6523Radial artery occlusion: predictors, methods for reducing the frequency of complications-a single center study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Ognerubov ◽  
A Tereshchenko ◽  
E Merkulov ◽  
S Provatorov ◽  
G Arutyunyan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Angiography ◽  
Radial Artery ◽  
Stable Coronary Artery Disease ◽  
Ulnar Artery ◽  
Coronary Intervention ◽  
Artery Occlusion ◽  
Careful Examination ◽  
Radial Access ◽  
Short Time

Abstract Radial access has great advantages in terms of the frequency of complications, but it has one specific complication - radial artery occlusion (RAO). This complication often does not manifest itself in any way; however, it limits the use of access for the future interventions. Aim To compare methods of short and traditional hemostasis and to identify the main predictors of RAO after radial access. Materials and methods During the period from 2012 to 2018, 2000 patients were included in the study, which consisted of two parts: prospective - 1000 patients who underwent coronary angiography and percutaneous coronary intervention (PCI) with stable coronary artery disease, and retrospective part of the study, which included 1000 patients admitted for PCI from other clinics. In a prospective study, patients were divided into two groups: after coronary angiography and PCI, respectively (n=500 in the coronary angiography group and n=500 in the PCI group), and then randomized. Hemostatic bandages in the first group of patients (n=250) were removed after 12–24 hours, in the second group (n=250) - after 4±1 hours. When the occlusion of the radial artery was detected, all patients underwent an hour-long compression of the ipsilateral ulnar artery to recanalize acute RAO. Results The frequency of RAO in the retrospective part of the study was 21.8%. The frequency of RAO in the prospective part of the study was 10.2% with a traditional time hemostasis and 1.4% with a short-time compression (P<0.001). Predictors of the RAO are illustrated in table 1. Predictors of bleeding were PCI (OR 0.12, 95% CI 0.01–0.67, P=0.05) and weight (OR 1.09, 95% CI 1.02–1.18, P=0.01). Table 1. Predictors of RAO Variables Odds ratio 95% Confidential interval Significance, P Traditional-time hemostasis 8.78 4.2–21.5 <0.001 Diabetes mellitus+smoking 18.1 12.7–26.7 <0.001 Diabetes mellitus 0.45 0.25–0.83 0.009 Body mass index 0.95 0.91–0.99 0.02 Male 1.75 1.01–3.18 0.05 Protein C 0,86 0,75–0,96 0,01 Conclusion Careful examination of the patient for detecting RAO before and after interventions is essential. Short hemostasis with compression of the ipsilateral ulnar artery reduce the frequency of RAO. For short-time hemostasis, special attention should be paid to patients after PCI and with low BMI, as far as these factors are associated with a greater risk of bleeding after removal of the compression bandage.

OUTCOME OF BRAIN ABSCESS BY CLOSTRIDIUM PERFRINGENS

Neurosurgery ◽  
2007 ◽  
Vol 61 (6) ◽  
pp. E1339-E1339 ◽  
Author(s):  
Chaim B. Colen ◽  
Mahmoud Rayes ◽  
Setti Rengachary ◽  
Murali Guthikonda
Keyword(s):  
Brain Abscess ◽  
Clostridium Perfringens ◽  
Soft Tissues ◽  
Severe Infection ◽  
Surgical Excision ◽  
Penicillin G ◽  
Necrotic Tissue ◽  
Excellent Outcome ◽  
Computed Tomographic ◽  
Antibiotic Coverage

Abstract OBJECTIVE Despite the aggressive infection of soft tissue caused by Clostridium perfringens (gas gangrene-necrotizing fasciitis), a brain abscess with this bacteria treated by early surgical excision, debridement of necrotic tissue, and antibiotic coverage may be expected to have a good recovery. Long-term follow-up has not been well established in this group of patients. We report this case to show the outcome at 3 years post surgical and antibiotic treatment for C. perfringens brain abscess and stress the need for urgent intervention to achieve good outcome. We also present a literature review of Clostridial brain abscesses since the 1960s. CLINICAL PRESENTATION A 53-year-old man was brought to the emergency room after having a witnessed seizure status postassault 3 days before admission. On presentation, he was febrile, disoriented, lethargic, and demonstrated right upper extremity weakness. A computed tomographic scan of the head showed a left frontoparietal depressed cranial fracture complicated with gas and intraparenchymal air fluid level cavity. INTERVENTION Emergent surgery for debridement and excision of necrotic tissue was performed. Empiric intravenous antibiotic therapy was started and penicillin G was added for 6 weeks after C. perfringens was demonstrated. CONCLUSION Despite the severe infection and effect of C. perfringens in soft tissues in the brain, it appears that emergent surgical debridement and antibiotic coverage will yield an excellent outcome for these patients.

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