Abstract
Introduction: The palmar irrigation has been the subject of research in different population groups using direct anatomical dissection. However, there is no standardized classification of superficial palmar arches, which leads the different authors to design own classifications.
Objective: to determine the different patterns of superficial palmar arch, and the clinical and surgical revelance of the various anatomical variants associated with this structure. Research methodology: A literature search was performed in data bases Medline, Ovid, Proquest, Cochrane, Scielo, Lilacs and Hinary, besides classical texts of anatomy and surgery. Retrospective and cross-sectional studies were selected in cadaveric specimens made in different population groups between 1987 to 2014. Results: It was used the superficial palmar arch classification established by Lippert and Pabst, that presented the complete superficial palmar arch as the most common vascular pattern, with a prevalence of 56.7%, in which was the most common subtype the classic radio-ulnar (64%). The prevalence of incomplete surperficial palmar arch was 48.8%, with a subtype of ulnar pattern reported in 24.7% of the samples tested. Conclusions: Adequate knowledge of the different patterns of palmar Irrigation is essential for successful approaches in hand surgery, and for understanding the pathophysiology of diseases related to employment as hypothenar hammer syndrome. MÉD UIS. 2015;28(3):363-9.
Keywords: Anatomical Variation. Superficial Palmar Arch. Radial Artery. Ulnar Artery.
References
Drake RL, Vogl AW, Mitchell AM. Gray Anatomía para Estudiantes. 2 ed. España: Elsevier; 2010.
Gellman H, Botte MJ, Shankwiler J, Gelberman RH. Arterial patterns of the deep and superficial palmar arches. Clin Orthop Relat Res. 2001; 383:41–6.
Umapathy S, Kamala E, Muhil M, Nalina K. A Study of variations in the formation of superficial palmar arch in the rural population of sourthern Tamilnadu. Int J Anat Radio Surg. 2012; 1(1):7–11
Pansky B. Anatomía humana. 6ed. México: McGraw Hill Interamericana; 1996.
Calenoff L. Angiography of the hand: guidelines for interpretation. Radiology. 1972; 102(2):331-5.
Navia JL, Olivares G, Ehasz P, Gillinov AM, Svensson LG, Brozzi N, et al. Endoscopic radial artery harvesting procedure for coronary artery bypass grafting. Ann Cardiothorac Surg. 2013; 2(4):557-64.
Kamienski RW, Barnes RW. Critique of the Allen test for continuity of the palmar arch assessed by doppler ultrasound. Surg Gynecol Obstet. 1976; 142(6):861-64.
Pola P, Serricchio M, Flore R. Manasse E, Favuzzi A, Possati GF. Safe removal of the radial artery for myocardial revascularization: a Doppler study to prevent ischemic complications to the hand. J Thorac Cardiovasc Surg. 1996;112(3):737-44.
Ottone NE, Prum N, Dominguez M, Blasi E, Medan C, Shinzato S, Et al. Analysis and clinical importance of superficial arterial palmar irrigation and its variants over 86 cases. Int J Morphol. 2010; 28(1):157- 64.
Jaschtschinski SN. Morphologie und Topographie des Arcus volaris sublimis und profundus des Menschen. Anat Hefte. 1897;7:161–88.
Coleman SS, Anson BJ. Arterial patterns in the hand based upon a study of 650 specimens. Surg Gynecol Obstet. 1961;113:409-24.
Ikeda A, Ugawa A, Kazihara Y, Hamada N. Arterial patterns in the hand based on a three-dimensional analysis of 220 cadaver hands. J Hand Surg. 1988;13(4):501-09.
Lippert H, Pabst R. Arterial variations in man: classification and frequency. 1ed. Munich: JF Bergmann Verlag; 1985. p 34-73.
Feigl GC, Petrac M, Pixner T, Ulz H, Mörth C, Dreu M. The superficial palmar arch and median artery as an example of misleading results due to a small number of investigated specimens or the use of different classifications. Ann Anat. 2012;194(4):389-395.
Jelicic N, Gajisin S, Zbrodowski A. Arcus palmaris superficialis. Acta Anat. 1988;132(3):187–190.
Özkus K, Pestelmaci T, Soyluoglu AI, Akkin AM, Özkus I. Folia Morphol. 1998:57(3);251–255.
Ruengsakulrach P, Eizenberg N, Fahrer C, Fahrer M, Buxton BF. Surgical mplications of variations in hand collateral circulation:anatomy revisited. J Thorac Cardiovasc Surg. 2001;122(4):682-6.
Loukas M, Holdman D, Holdman S. Anatomical variations of the superficial and deep palmar arches. Folia Morphol. 2005;64(2):78–83.
Tagil SM, Cicekcibasi AE, Ögün TC, Büyükmumcu M, Salbacak A. Variations and clinical importance of the superficial palmar arch. S.D.Ü. Tip Fak. Derg. 2007:14(2);11–6.
Bataineh ZM, Habbal O, Moqattash ST. Variations in the superficial palmar arch of the hand. Ital J Anat Embryol. 2009:114(1);11–20.
Joshi SB, Vatsalaswamy P, Bahetee BH. Variation in formation of superficial palmar arches with clinical implications. J Clin Diagn Res. 2014:8(4);6–9.
Al-Turk M, Metcalf WK. A study of the superficial palmar arteries using the Doppler Ultrasonic Flowmeter. J Anat. 1984;138(Pt 1):27–32.
Patnaik VVG, Kalsey G, Singla RK. Palmar Arterial Arches- A Morphological Study. J Anat Soc. 2002: 51(2);187-93.
Arruda SR, Nunes T, Silva AR, Paula AR, Salgado JL. Morphologic
variations of the superficial palmar arch. Acta Cir Bras. 2003;18(3):183-8.
Guzmán S, Castro-Govea Y. Variantes del arco arterial palmar superficial. Estandarización del concepto arcus: un estudio anatómico en la población mexicana. Med Univer. 2004;6(24):188-93.
Fazan VP, Borges CT, da Silva JH, Caetano AG, Filho OA. Superficial palmar arch: an arterial diameter study. J Anat. 2004;204(4):307-11.
Bilge O, Pinar Y, Ozer MA, Gövsa F. A morphometric study on the superficial palmar arch of the hand. Surg Radiol Anat. 2006;28(4):343–50.
Elizondo-Omaña RE, García-Rodriguez MA, Tijerina O, GuzmánLópez S, De-la-Garza CO, López-Serna N, et al. Anatomical study of palmar archs: Diameter and Presentation. Int. J. Morphol. 2007;25(1):55-60
Bataineh ZM, Habbal O, Moqattash ST. Variations in the superficial palmar arch of the hand. Ital J Anat Embryol. 2009;114(1):11–20.
Suman U, Jayanthi KS. A study of complete superficial palmar arches formed entirely by ulnar artery. J. Anat. Soc. India. 2011;60(2):199-201
Ziakas A, Klinke P, Mildenberger R, Fretz E, Williams MB, Della SA et al. Comparison of the radial and femoral approaches in left main PCI: a retrospective study. J Invasive Cardiol. 2004;16(3):129-32.
Ziakas A, Klinke P, Mildenberger R, Fretz E, Williams MB, Della SA et al. A comparison of the radial and the femoral approach in vein graft PCI. A retrospective study. Int J Cardiovasc Intervent. 2005;7(2):93-6.
Pullen RL. Realización del test de Allen modificado. Nursing. 2006;24(8):44.
Molinari G, Nicoletti I, De-Benedictis M, Terraneo C, Morando G, Turri M et al. Safety and efficacy of the percutaneous radial artery approach for coronary angiography and angioplasty in the elderly. J Invasive Cardiol. 2005;17(12):651-4
Dahm JB, Vogelgesang D, Hummel A, Staudt A, Völzke H, Felix SB. A randomized trial of 5 vs. 6 french transradial percutaneous coronary interventions. Catheter Cardiovasc Interv. 2002;57(2):172-6.
Conklin LD, Ferguson ER, Reardon MJ. The technical aspects of radial artery harvesting. Tex Heart Inst J. 2001;28(2):129-31.
Espinoza JC, Zgrablich C, Ruda-Vega PF. Cardiopulmonary bypass with extracorporeal circulation: surgical technique. Rev. Arg. Res. 2012;17(1):19-24
Mertens RM, Kramer AS, ValdesFE. Síndrome del martillo hipotenar. Rev Med Chile. 1995; 123: 345-9.
Conn JJr, Bergan JJ, Bell JL. Hypothenar hammer syndrome: posttraumatic digital ischemia. Surgery. 1970;68(6):1122-8.