Persistent Median Arteries: A Cadaveric Study of Prevalence, Variants, and Clinical Relevance

The median artery, an embryonic vessel, may persist into adulthood as the persistent median artery (PMA), a variant of clinical and surgical relevance. In a cadaveric study of 23 upper limbs from 12 donated adult cadavers, PMA was identified in eight limbs (34.8%). Half of these (4/8 limbs, 17.4%) pierced the median nerve in the proximal forearm, an uncommon finding. Two palmar-type PMAs were identified, both of which exhibited atypical terminal branching in the hand (2/23 limbs, 8.7%). These anatomical variations may contribute to median nerve compression syndromes, such as carpal tunnel syndrome, and pose risks during surgical procedures of the forearm and wrist. Awareness of PMA anatomy, including its prevalence and variant patterns, is important for accurate diagnosis and safe surgical planning.