A radial artery originating from the thoracoacromial artery

Purpose

The purpose of this case report is to report a rare vascular variation in the upper limbs because of its clinical importance and embryological implication.

Methods

During the educational dissection of a 73-year-old Korean male cadaver`s right upper limb, we found a variant branch which is originated from the thoracoacromial artery.

Results

The variant branch from the thoracoacromial artery ran to the distal forearm in the deep fascia. Because it finally coursed like the radial artery in the forearm and the palm, we defined the variant artery as superficial brachioradial artery (SBRA). In the cubital region a little below the intercondylar line, the brachial artery gave off a small communicating branch to SBRA, and continued as the ulnar artery.

Conclusions

We reported this unique variation and discussed its clinical and embryological implication.

     

Rare case of the inferior mesenteric artery and the common hepatic artery arising from the superior mesenteric artery

We found a case in which inferior mesenteric artery and the common hepatic artery arose from the superior mesenteric artery, forming the common hepatomesenteric trunk, during a routine dissection carried out at Iwate Medical University in 2002. This variation is rare, but can be embryonically explained. A change in the positions of the disappearance of the ventral splanchnic arteries and the longitudinal anastomotic channel results in variations in the system of arteries distributed to the digestive organs. In the present case, the longitudinal anastomotic channel between the superior and the inferior mesenteric arteries survived to form the common mesenteric artery, which was joined by the common hepatic artery, forming the common hepatomesenteric trunk.     

趾足底固有动脉趾端动脉弓及其分支的显微解剖

目的　解剖观测趾足底固有动脉趾端动脉弓及其分支的解剖学特点。 方法　选取新鲜成人足标本8只,分别经足背动脉灌注红色乳胶,对第2趾趾足底固有动脉进行显微解剖,观察趾足底固有动脉弓的出现概率,位置及其口径,趾端动脉弓发出的弓上动脉的起始部位,走行方向,分支数目及血管口径情况。 结果　第2趾趾足底固有动脉趾端动脉弓恒定,动脉弓的外径为0.5~0.8 mm,平均外径为0.64 mm,动脉弓距趾端的距离为9.5~13.0 mm,平均为11.1 mm。动脉弓上发出5支恒定的分支,即趾端弓上动脉,我们将其命名为第1~5支趾端弓上动脉（由胫侧至腓侧）。 结论 第2趾趾端动脉弓及其发出的弓上动脉解剖恒定,可以采用弓上动脉为蒂的微型轴型皮瓣改善第2足趾再造后外形。     

A retroesophageal right subclavian artery with the right vertebral artery originating from the right common carotid artery

The right subclavian artery was found to be retroesophageal, and the right vertebral artery originated from the right common carotid artery in a 46-year-old female cadaver. The right subclavian artery stemmed from the upper portion of the thoracic aorta, posterior and inferior to the origin of the normal left subclavian artery. The right and left common carotid arteries originated from the aortic arch in close proximity. Compression of the trachea anteriorly could not be demonstrated. The right inferior laryngeal nerve was nonrecurrent. A brief review of the literature shows the importance of knowledge concerning the aberrant right subclavian artery for the roentgenologist and the surgeon in the treatment of patients with this vascular anomaly.     

The common hepatic artery arising from the left gastric artery

We report three cases with a rare anatomic variation, in which the common hepatic artery (CHA) arose from the left gastric artery. Fewer than ten cases with this anatomic variation have been published in the literature consulted. In each patient, multidetector-row CT image with 3D reformation demonstrated that the hepatic artery arises from the left gastric artery and runs through the lesser omentum. The left, middle, and right hepatic arteries derived from this artery, and no other arterial supply to the liver was seen. The course of the gastroduodenal artery was variable; it derived from the CHA, the splenic artery, or both. No variation was noted in the splenic artery and the superior mesenteric artery.     

Continuation of the ascending cervical artery as the occipital artery in man

We report an elderly male cadaver with unilateral anomalous continuation of the ascending cervical artery as the occipital artery. The ascending cervical artery was enlarged from its origin and supplied segmental branches through the intervertebral foramina. At the upper cervical spine, the ascending cervical artery continued as the occipital artery providing the branches normally seen stemming from this artery. No other vascular anomalies were noted in this specimen. This anatomical curiosity should be kept in mind by the clinician or academic who may manipulate this anatomical area.     

挠、尺动脉的无创血液流动阻力测量

在肘部和腕部放置气袖,指尖放置脉搏传感器,同步放气,肘部达到收缩压时,腕部开始收到脉搏信号,腕部达到收缩压时,指尖收到脉搏信号,于是测出压降,近而得到阻力。     

The superficial ulnar artery originating from the left brachial artery

An anomalous superficial ulnar artery was found in the left arm of a 60-year-old man during anatomical dissection. It originated from the brachial artery approximately 6 cm distally to profound brachial artery. It crossed over the median nerve and coursed ventral to the nerve, but inferior to the bicipital aponeurosis and superficial to the flexor muscles. At the palm, it formed the superficial and deep palmar arches together with the branches of the radial artery. The clinical importance of the anomalous ulnar artery is discussed.     

An aberrant cerebellar artery originating from the internal carotid artery

The aberrant origin of the cerebellar arteries from anterior cerebral circulation is a quite rare vascular variation. Herein, we report a 52-year-old white female with angiographically occult subarachnoid hemorrhage. Left superior and anterior inferior cerebellar arteries were not detected. An aberrant cerebellar artery was noted to arise from the left cavernous internal carotid artery and terminated in the distribution of the ipsilateral superior and anterior inferior cerebellar arteries. This variant artery might likely have resulted from an abnormal regression of fetal anterior-to-posterior circulation connections, and may represent a fetal-type cerebellar artery. A review of the anatomy and clinical significance of the variant is presented.     

The middle suprarenal artery arising from the superior mesenteric artery

We observed a rare case of the middle suprarenal artery branching out from the superior mesenteric artery in a 78-year-old male. This atypical artery enters the right suprarenal gland that was also supplied by the superior and the inferior suprarenal arteries as usual. In embryonic stages, vasculature of the vitelline system and the gonadal system is differentially organized. The superior mesenteric artery has been generally thought to be pure vitelline, since there has been no evidence that the superior mesenteric artery supplies other organs than digestive. We then speculate that the present middle suprarenal artery is a remnant of the embryonic gonadal artery from the superior mesenteric artery, whereas a stem artery to the testis disappeared. Surgeons should take notice of the middle suprarenal artery when operations are conducted around the superior mesenteric artery.     

A middle meningeal artery which arises from the internal carotid artery in which the first branchial artery participates.

A middle meningeal artery arising from the internal carotid artery was found in the right half of the head of an 85-year-old male cadaver during student dissection practice. It arose from the lateral aspect of the internal carotid artery in the carotid canal, arrived at the foramen lacerum after running forward. It then ran backward under the trigeminal ganglion and took the usual course after passing its posterior margin. On one hand, the maxillary artery did not issue the middle meningeal artery, gave off only a small twig supplying the lateral pterygoid muscle at the corresponding position. It was corroborated by the fact that the foramen spinosum was absent in this example. During usual development, the middle meningeal artery primarily springs from the supraorbital branch of the stapedial artery that arises from the dorsal part of the second branchial artery. Later, by the formation of the external carotid artery connecting with the common trunk of the infraorbital and mandibular branches (maxillomandibular division) of the stapedial artery and by the atrophy of the proximal part of it, the middle meningeal artery is finally supplied by the external carotid artery. But in this example, it is supposed that the middle meningeal artery arose from a more distal position of the internal carotid artery owing to the persistence of the anastomosis between the dorsal part of the first branchial artery and the supraorbital branch and the interruption of the connection between the supraorbital branch and maxillomandibular division of the stapedial artery.     

Unusual origin of the ophthalmic artery and occlusion of the central retinal artery

Summary Any variations in the origin of the ophthalmic a. are uncommon and well-explained by the comparative anatomy and human embryology. A unique case is reported of an ophthalmic a. arising from the middle meningeal a. associated with an occlusion of the central retinal a. Embryologic variations which can give such an unusual origin are discussed. Although this association may be fortuitous, we consider that an unusual origin of the ophthalmic a. could be a further factor for an occlusion of the central retinal a.

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Variation d'origine de l'artère ophtalmique et occlusion de l'artère centrale de la rétine

Résumé Les variations d'origine de l'artère ophtalmique sont rares et bien expliquées par l'étude de l'anatomie comparée et de l'embryologie humaine. Nous rapportons le cas exceptionnel d'une variation d'origine de l'artère ophtalmique à partir de l'artère méningée moyenne associée à une occlusion de l'artère centrale de la rétine. Les variations embryologiques pouvant donner naissance à cette origine inhabituelle sont discutées. Bien que cette association puisse être totalement fortuite, nous pensons qu'une variation d'origine de l'artère ophtalmique peut constituer un facteur favorisant pour une occlusion de l'artère centrale de la rétine.

     

Rare case of the inferior mesenteric artery arising from the superior mesenteric artery

The authors observed a variation of the inferior mesenteric artery, which arose from the superior mesenteric artery, in a 69-year-old Japanese male cadaver during dissection in 1984. In this case, no rudiment of the ordinary inferior mesenteric artery could be found on the abdominal aorta. There are few reports of this variation, and an extensive search of the available literature revealed only four cases, including two in Japan. Such a variation had been somewhat inadequately described as an "absence of the inferior mesenteric artery" in the previous reports, but we avoided this terminology, because all of the cases possessed an artery, which, though arising from the superior mesenteric artery instead of the abdominal aorta, had the same branches as a normal inferior mesenteric artery. Consistent with findings observed in the previous cases, the unusual inferior mesenteric artery arose as the first branch of the superior mesenteric artery, with the common trunk of both mesenteric arteries originating from the abdominal aorta at a level at which an ordinary superior mesenteric artery would arise. It is for this reason that we did not adopt another acceptable name, that is, "the common mesenteric artery," for this variation. The variation can be explained as the result of an unusual development of the embryonic artery system, which comprises a number of ventral splanchnic arteries interconnected by longitudinal anastomotic channels to supply the primitive digestive tube.     

Bilateral aberrant origin of the inferior thyroid artery from the common carotid artery

The thyroid gland is mainly supplied by the superior and inferior thyroid arteries, with the latter being its principal arterial supply in adults. The inferior thyroid artery usually arises from the thyrocervical trunk, and less frequently from the subclavian artery. Rarely, it may originate from the vertebral artery or the common carotid artery. In the present report, we describe a unique case of a 56-year-old patient, undergoing total thyroidectomy and level VI lymph node dissection for papillary thyroid carcinoma, with aberrant origin of both inferior thyroid arteries from the common carotid arteries.