Prevalence and Variations of the Median Artery: A Pilot Study in a Sample of Lithuanian Cadavers

Abstract

Objective This pilot project aimed to assess the prevalence and variations of the median artery (MA) on a small scale in preparation for a large-scale study investigating MA in Lithuanian cadavers. Methods Eight formalin-fixed adult female cadavers were used in this study. Dissection was performed to allow for the observation of MA presence, type, origin, termination, and relations with other structures. The gathered data was analyzed, and a literature search was performed to compare the findings. Results MA was found in 10 of the 16 upper limbs examined; therefore, the incidence of MA in the present study was 62.5%. Of the 10 MAs found, six (60%) were of the antebrachial type (a-MA), and four (40%) were palmar (p-MA). Thus, the prevalence of a-MA and p-MA in the upper limbs examined was 37.5% (N = 6/16) and 25% (N = 4/16), respectively. Among the six cadavers that were found to possess MA, it was identified bilaterally in four (66.7%) and unilaterally in two (33.3%). The associations between the antimere and the presence of MA or MA-type were not statistically significant. MA most commonly originated from the common interosseous artery (50%, N = 5/10), followed by the ulnar artery (UA) (40%, N = 4/10), and the anterior interosseous artery (10%, N = 1/10). Two (33.3%) of the six a-MAs terminated in the mid-forearm, while four (66.7%) a-MAs ended in the distal forearm. Meanwhile, three (75%) of the four p-MAs terminated by joining the UA, while one (25%) terminated as the first common palmar digital artery. In the forearm, nine (90%) of the 10 MAs traveled anteriorly to the anterior interosseous nerve (AIN), and only one (10%) traveled posteriorly to the AIN. Additionally, one (10%) of the 10 MAs was found to pierce the median nerve. Conclusions Our findings confirm the variability in MA characteristics reported by previous studies. The high incidence of MA discovered in our sample calls attention to the importance of being aware of MA in a clinical setting, as this would allow for a timely and accurate response to a potential pathology associated with this structure.

Keywords: anatomical variations; antebrachial type; arteries of the upper limb; cadaveric study; median artery; palmar type; persistent median artery.

Figure 1. Arteries in the proximal forearm as seen on dissection. The median artery is absent.

UA: ulnar artery (colored blue); RA: radial artery (colored green); CIA: common interosseous artery (colored yellow); AIA: anterior interosseous artery (colored yellow); PIA: posterior interosseous artery (colored yellow); MN: median nerve; colored red: a muscular branch stemming from CIA

Figure 2. Different origination variants of the median artery were observed.

A: MA originating from the CIA; B: MA originating from the UA; C: MA originating from the AIA UA: ulnar artery (colored blue); RA: radial artery (colored green); CIA: common interosseous artery (colored yellow); AIA: anterior interosseous artery (colored yellow); PIA: posterior interosseous artery (colored yellow); MA: median artery (colored red); MN: median nerve

Figure 3. Median artery terminating between the fibers of a muscle in the mid-forearm.

MA: median artery (colored red); MN: median nerve

Figure 4. Different termination variants of palmar MA were observed.

A: MA terminating as the first common palmar digital artery; B: MA flowing into the ulnar artery; C: MA anastomosing with the ulnar artery via a branch and continuing towards the first web space UA: ulnar artery (colored blue); CPDAs: common palmar digital arteries (colored blue); PPDA: proper palmar digital artery to the fifth digit (colored blue); SPA: superficial palmar arch (colored blue); MA: median artery (colored red); MN: median nerve