Procedure and risks were explained and informed consent obtained. Conscious sedation administered and
continuous physiological monitoring by nursing staff. The right groin was prepped, draped, and anesthetized in the usual
fashion. Right common femoral artery was punctured with a 19-gauge singlewall needle and a guidewire advanced. A
5-French sheath was placed. A 5-French HN2 catheter was advanced and used to selectively catheterize the left and
right subclavian arteries and angiography obtained. The catheters were then selectively advanced down to the distal
brachial artery for improved visualization of distal upper extremity flow bilaterally.
Findings:
RIGHT UPPER EXTREMITY angiography is essentially unremarkable. There is no evidence of stenotic or occlusive
disease and no thrombosis. There is a dominant ulnar artery that supplies the the superficial palmar arch while the radial
artery is more diminutive in caliber supplies the intact but diminutive deep palmar arch. No significant disease of the
common and proper palmar digital arteries.
LEFT UPPER EXTREMITY angiography is unremarkable from the level of the aortic arch through the left
subclavian/axillary/brachial artery. Normal brachial artery bifurcation and unremarkable proximal aspects of the ulnar and
radial arteries.
There is however initially lack of any definitive flow seen to the hand so a 3-French microcatheter was advanced the
proximal forearm to the level of the brachial bifurcation and digital angiography obtained from this point on. There is once
again sluggish distal flow of the forearm vessels. Similar to the right arm there is a dominant ulnar artery this is a vessel
which distal sluggish flow. There appears to be two focal modest stenoses of the ulnar artery around the level of the wrist
and termination of the vessel at the proximal arch level feeding third fourth and fifth dorsal metacarpal arteries with lack of
an intact/patent superficial palmar arch. Similar to the right arm there is more diminutive radial artery but it feeds an intact
deep palmar arch as well as diminutive metacarpal vessels demonstrated.
i have an idea but kind of confused about the brachial artery?
continuous physiological monitoring by nursing staff. The right groin was prepped, draped, and anesthetized in the usual
fashion. Right common femoral artery was punctured with a 19-gauge singlewall needle and a guidewire advanced. A
5-French sheath was placed. A 5-French HN2 catheter was advanced and used to selectively catheterize the left and
right subclavian arteries and angiography obtained. The catheters were then selectively advanced down to the distal
brachial artery for improved visualization of distal upper extremity flow bilaterally.
Findings:
RIGHT UPPER EXTREMITY angiography is essentially unremarkable. There is no evidence of stenotic or occlusive
disease and no thrombosis. There is a dominant ulnar artery that supplies the the superficial palmar arch while the radial
artery is more diminutive in caliber supplies the intact but diminutive deep palmar arch. No significant disease of the
common and proper palmar digital arteries.
LEFT UPPER EXTREMITY angiography is unremarkable from the level of the aortic arch through the left
subclavian/axillary/brachial artery. Normal brachial artery bifurcation and unremarkable proximal aspects of the ulnar and
radial arteries.
There is however initially lack of any definitive flow seen to the hand so a 3-French microcatheter was advanced the
proximal forearm to the level of the brachial bifurcation and digital angiography obtained from this point on. There is once
again sluggish distal flow of the forearm vessels. Similar to the right arm there is a dominant ulnar artery this is a vessel
which distal sluggish flow. There appears to be two focal modest stenoses of the ulnar artery around the level of the wrist
and termination of the vessel at the proximal arch level feeding third fourth and fifth dorsal metacarpal arteries with lack of
an intact/patent superficial palmar arch. Similar to the right arm there is more diminutive radial artery but it feeds an intact
deep palmar arch as well as diminutive metacarpal vessels demonstrated.
i have an idea but kind of confused about the brachial artery?