The Hip - book
Home » Bones » Hand » Radial Artery

Radial Artery

- See: Vascular Problems of the Wrist and Hand:

- Radial Artery in the Forearm:
      - in the mid forearm, the radial artery lies beneath the brachioradialis
      - here the brachioradialis recieves arterial branches just below elbow;

- Radial Artery in Wrist:
    - at wrist ulnar artery terminates in superficial palmar arch that provides most of the blood supply to the fingers;
    - radial artery terminates in deep palmar arch, which provides blood to thumb & thenar side of index finger & gives rise to collat. branches;
         - radial artery becomes deep palmar as it enters palm between two segments of the first dorsal interosseous muscle;
         - it passes into palm between oblique & transverse heads of adductor pollicis & then forms deep palmar arch  by anastomosing w/ deep branch of ulnar artery;
    - in the web space, the artery divides into princeps pollicis and radialis indicis;
    - radialis indicis:
         - this runs along the radial side of index finger;
    - princeps pollicis artery branches from the radial artery before it is covered by the oblique head of the adductor pollicis muscle;
           - it runs along volar aspect of adductor muscle between FPB and tendon of the FPL;
           - at the thumb, it divides into two palmar digital branches;
    - at level of MP joint, it branches into two volar arteries of thumb;
    - ulnar artery is prime contributor to superficial arch which also receives a branch of superficial branch of the radial artery;

- Puncture of Artery:
    - radial artery is frequently cannulated percutaneously for ABG monitoring and for continuous pressure monitoring;
    - incidence of radial artery thrombosis after cannulation is approx, 10-20%, but fortunately, the condition is asymptomatic
         in most pts, because of collateral circulation from the ulnar artery;
   - because, >  20% of pts have incomplete palmar arch, these patients are at risk for thrombosis of the radial artery;
         - initial treatment is w/ Fogarty catheter (size 2 Fr);
   - allen test should be performed in all patients prior to radial artery cannulation;
         - alternative is to place a pulse oximeter to the thumb and to compress the radial artery;
                - if there is an incomplete superficial palmar arch, then the pulse ox will not register on the thumb (w/ radial a. compression);
   - references:
         - Radial artery cannulation. A prospective study in patients undergoing cardiothoracic surgery.
         - Radial artery cannulation: influence of catheter size and material on arterial occlusion.
         - Aspirin pretreatment prevents post-cannulation radial-artery thrombosis.  
         - Long-term radial artery cannulation: effects on subsequent vessel function.
         - Radial arterial function following percutaneous cannulation with 18- and 20-gauge catheters.
         - Acute exacerbation of carpal tunnel syndrome after radial artery cannulation.
         - Wrist hyperextension leads to median nerve conduction block: implications for intra-arterial catheter placement.
         - Should an Allen test be performed before radial artery cannulation?

The results of radial and ulnar arterial repair in the forearm. Experience in three medical centers.

An Experience with Upper-Extremity Vascular Trauma.

Surgical Treatment of Distal Ulnar Artery Aneurysm.

Upper Extremity Arterial Injury in Athletes.

Radial or ulnar artery laceration. Repair or ligate.

Arterial abnormalities of the hand in athletes.

Spontaneous retrocarpal radial artery thrombosis: a report of two cases.

Report of a rare human variation: absence of the radial artery.