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Scripta Scientifica Medica

Variant formation of the superficial palmar arch and its clinical significance

A. Iliev, G. Kotov, G. Georgiev, B. Landzhov, I. Dimitrova, L. Malinova, D. Hinova-Palova


The vascular anatomy of the hand is challenging due to a high prevalence of previously identified variations. These variations were usually found in the palmar arches of which the superficial palmar arch (SPA), through which the hand receives its major blood supply, has been shown to be the most variable. The SPA has been broadly divided into two categories: complete and incomplete. The difference resides in the presence or absence of an arch formed either by a single artery or between the constituting vessels. Variations seem to be more prevalent within the complete arch category. Here we describe a variant formation of the superficial palmar arch and an arterial circle at the base of the thumb found during routine dissection classes in the right hand of a 72-year-old male cadaver. The SPA was formed by the superficial branch of the ulnar artery and a communicating branch from the deep palmar arch (DPA) which passed between the oblique and transverse heads of adductor pollicis muscle before completing the arch. This anastomosis formed an arterial circle in the palm. The knowledge of arterial anatomy and its morphology may be of use in graft surgeries, especially when the arteries of the upper limb are harvested for coronary artery bypass grafts. Recent advances in the microsurgical procedures for reconstructive hand surgeries have necessitated a clear understanding of the arterial variations. The use of the radial artery as the arterial bypass conduit is becoming popular among various hospitals. The morphology of the arterial arches in the hand is important for microvascular surgeons as well as orthopaedicians.

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About The Authors

A. Iliev

G. Kotov

G. Georgiev

B. Landzhov

I. Dimitrova

L. Malinova

D. Hinova-Palova

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