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Maingard, J. Bilateral thalamic infarcts. Case study, Radiopaedia. Central Nervous System. Full screen case. Case with hidden diagnosis. Full screen case with hidden diagnosis. Zou men van linkerriem en rechterriem spreken, dan zou de bedoeling niet duidelijk zijn. Sommige schepen, vooral veerboten op een korte afstand, zijn voor en achter gelijk.
In dat geval ligt de 'virtuele boeg' aan de zijde waarheen de kijkt tijdens de bediening van zijn stuureenheid. Vessel structures are largely bilaterally symmetrical, meaning they have mirror-image left and right halves if divided sagittally. Jefferson , G. On the saccular aneurysms of the internal carotid artery in the cavernous sinus.
Logue , V. Saccular aneurysms of the internal carotid artery in the cavernous sinus occurring bilaterally. Mahoudeau , D. Cited by Alpers et al. Sign in Sign up. Advanced Search Help.
Jacob Seltzer M. Coronary angiography and percutaneous coronary intervention were performed via the brachial artery since transradial percutaneous coronary intervention failed. The highlight of this case is that it could be the first case to be reported with bilateral absence of radial artery in adults. Peer Review reports. Knowledge of arterial variations has a number of important implications for medical practice. The radial artery is used for the access of coronary angiography CAG and percutaneous coronary intervention PCI , as well as for coronary artery bypass surgery.
Therefore, doctors should be aware of such vascular anomalies of the upper limb. Variations of upper limb arteries are common, and there are many such related reports[ 1 — 6 ]. Documentation of anatomic variant such as congenital absence of radial artery is scarce[ 7 — 12 ], and most cases were unilateral radial artery absence. During a coronary angiography of a year-old man, we encountered a very rare congenital bilateral absence of radial arteries.
A year-old Chinese man, admitted into the inpatient cardiovascular ward on the 9 th July , was diagnosed with anterior acute myocardial infarction AMI after more than 12 hours following the onset of symptoms. Physical examination of the patient before the procedures found no functional disabilities of both arms and the hands were warm and well perfused.
Under the guidance of the pulse, the right distal artery was successfully punctured. However, the guidewire could not traverse through smoothly subsequently. Therefore as a routine, arteriography of right upper-limb arteries was performed to delineate the anatomic features.
The arteriogram of the right arm showed an absence of the radial artery see Figure 1 and the arteriogram of the left upper limb arteries were also discovered to be similar to the right see Figure 2. Absence of right radial artery. Radial artery, was not present and the anterior interosseous artery was unusually large in size. The anterior interosseous artery which coursed vertically between radius and ulna in the distal forearm branches off into two small lateral arteries to supply blood to the hands.
One of the branches curled round the carpus and anastomosed with the branches of the ulnar artery, whereas the other branch traversed to radialis and became large-caliber vessel. Distal ulnar artery was small in size and together with the interosseous artery supplied blood to the hands.
Absence of left radial artery. Left upper extremity arteriography revealed exactly the same pattern, the anterior interosseous artery was the dominant blood supply to the forearm and hand, distal ulnar artery was small in size, provided the part supply of the hand. The patient had no history of operation or trauma. Right upper extremity arteriography see Figure 1 revealed that the radial artery, arising from the brachial or axillary artery, was not present and the anterior interosseous artery was unusually large in size.
No other vessel that coursed distally with resemblance to the radial artery was observed. An additional movie file shows this in more detail [see Additional file 1 ]. Left upper extremity arteriography see Figure 2 revealed exactly the same pattern, vessels of both forearms were symmetrical in course, An additional movie file shows this in more detail [see Additional file 2 ]. Miscellaneous variations and anomalies of the arterial pattern were fairly common in upper extremities[ 1 — 6 ].
However, case reports were on the absence of unilateral radial artery, the congenital absence of bilateral radial arteries was rare.
In , Charls[ 7 ] first reported an aged male specimen with the absence of radial artery and observed anterior interosseous artery instead in the right upper limb. However, the left radial artery was normal.
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