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Persistent median artery accidentally identified during radial artery catheterization: A case report
Shoko Nakamura1, Tetsuya Uchino1, Shigekiyo Matsumoto1
1Department of Anesthesiology, Faculty of Medicine, Oita University, Yufu City, Oita, Japan.
Radial artery catheterization is commonly performed using the pulse palpation method. However, anatomical variations, such as the persistent median artery-an embryonic structure that may persist into adulthood-can complicate this procedure. A 47-year-old female scheduled for laparoscopic surgery required radial artery catheterization for hemodynamic monitoring. Multiple attempts to place a 22-gauge catheter in the left radial artery were unsuccessful. During the procedure, a pulsating vessel was identified on the ulnar side of the radial artery. Vascular visualization devices revealed the presence of a persistent median artery, accompanied by the median nerve. Subsequently, real-time ultrasound guidance facilitated successful radial artery catheterization. Anatomical variations, such as the persistent median artery, can complicate radial artery catheterization and are not easily identified through pulse palpation alone. The use of vascular visualization devices is recommended to identify and navigate such variations, ensuring accurate catheter placement.
Radial artery catheterization is commonly performed using the pulse palpation method. However, anatomical variations, such as the persistent median artery-an embryonic structure that may persist into adulthood-can complicate this procedure. A 47-year-old female scheduled for laparoscopic surgery required radial artery catheterization for hemodynamic monitoring. Multiple attempts to place a 22-gauge catheter in the left radial artery were unsuccessful. During the procedure, a pulsating vessel was identified on the ulnar side of the radial artery. Vascular visualization devices revealed the presence of a persistent median artery, accompanied by the median nerve. Subsequently, real-time ultrasound guidance facilitated successful radial artery catheterization. Anatomical variations, such as the persistent median artery, can complicate radial artery catheterization and are not easily identified through pulse palpation alone. The use of vascular visualization devices is recommended to identify and navigate such variations, ensuring accurate catheter placement.
Related Concept Videos
01:11Assessment of radial pulse
The radial pulse, located at the wrist, is often the preferred site for assessing peripheral pulse because of its accessibility and dependability. The process of determining the radial pulse involves several steps:
01:25Assessment of apical radial pulse
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation
01:21Cardiac Catheterization II: Right Heart Catheterization
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01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation