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J Thorac Cardiovasc Surg 2001;122:682-686
© 2001 The American Association for Thoracic Surgery

Surgery for Aquired Cardiovascular Disease (ACD)

Surgical implications of variations in hand collateral circulation: Anatomy revisited

From the Department of Cardiac Surgery,^a Austin & Repatriation Medical Centre, and the Department of Anatomy and Cell Biology,^b The University of Melbourne, Melbourne, Victoria, Australia.

Received for publication Feb 2, 2001. Revisions requested March 14, 2001; revisions received April 24, 2001. Accepted for publication April 27, 2001. Abstract

Objectives: One of the risks associated with harvesting the radial artery is hand ischemia. Accordingly, this study investigated the variations of the hand collateral circulation.
Methods: Fifty hands of cadavers were examined. Variations of the palmar arches were recorded. A classic superficial palmar arch was defined as direct continuity between the ulnar artery and the superficial palmar branch of the radial artery. A classic complete deep palmar arch was defined as direct continuity between the radial artery and the deep branch of the ulnar artery.
Results: A classic superficial palmar arch was found in 10% (5/50) of hands, and a classic complete deep palmar arch was found in 90% (45/50) of hands. The superficial palmar branch of the ulnar artery supplied blood to all fingers in 66% (33/50) of hands. Although the superficial palmar branch of the ulnar artery was continuous with the radial artery in only 34% (17/50) of hands (including the classic type of superficial palmar arch), every hand had at least one major branch connecting the radial and ulnar arteries.
Conclusions: Variations in the terminations of the radial and ulnar arteries are common. Although the classic type of superficial palmar arch occurs relatively infrequently, there is always a significant anastomosis between the radial and the ulnar artery in the hand. This anatomic study confirms the presence of a collateral supply in the hand. In the absence of vascular disease, harvesting the radial artery should be regarded as a safe procedure.

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