Utility of Handheld Ultrasound in Identifying Millimeter-Sized Vasculature in Living and Cadaveric Subjects

Objective This study aims to investigate the utility of handheld, Bluetooth-capable ultrasound in identifying millimeter-sized vasculature in both living and cadaveric subjects. Methods Using handheld, linear ultrasound probes, the carpal tunnel of 87 living individuals (174 forearms) was assessed for the presence of a persistent median artery (PMA). Radial, ulnar, and persistent median arterial diameters were measured, along with forearm circumference. Using the same probes, 46 cadaveric forearms were assessed for the presence of a "potential" PMA. Those same forearms were subsequently dissected to confirm the presence of the artery.  Results A PMA was identified in 3.4% of individuals (1.7% of forearms). Radial, ulnar, and persistent median arterial diameters were 2.12 ± 0.40 mm, 1.89 ± 0.41 mm, and 0.82 ± 0.33 mm, respectively. The radial artery was significantly larger than the ulnar artery (p < 0.0001). In cadaveric subjects, four "potential" PMAs were identified by pre-dissection ultrasound. Upon dissection, only one of the "potential" PMAs was confirmed, and three previously unidentified PMAs were identified.  Conclusions The prevalence of PMA in living subjects was lower than previously reported. Additionally, handheld ultrasound had low accuracy in identifying PMAs in cadavers prior to dissection. This could be an indication that current handheld ultrasound lacks the sensitivity to identify millimeter-sized vasculature, such as a PMA. In both populations of subjects, key, non-anomalous anatomy was readily seen, indicating the utility of handheld ultrasound in the proper context.