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The Antebrachium
Published in Gene L. Colborn, David B. Lause, Musculoskeletal Anatomy, 2009
Gene L. Colborn, David B. Lause
Distally, from the ulnar artery, anterior and posterior ulnar recurrent arteries arise which take part in the anastomoses about the elbow. The radial artery also gives off a branch, called the radial recurrent artery, near the origin of the radial artery. The interosseous recurrent artery arises from the posterior interosseous artery in the extensor compartment.
A ‘recurrent’ coronary artery
Published in Acta Cardiologica, 2022
Meenu Bagarhatta, Ritu Agarwal, Rengarajan Rajagopal
Anatomically, the course of an artery is described as ‘recurrent’ when the artery originates at a distal location and courses proximally to supply an organ (for instance radial recurrent artery). The coronary arteries are seen to arise from the aortic sinuses and usually run distally without any retrograde course to supply the myocardium. Fifty-year-old lady with history of rheumatic mitral disease presented with progressive breathlessness and chest discomfort. Coronary CT angiogram performed pre-operatively to mitral valve repair, showed no obstructive atherosclerotic coronary disease. Mitral valve was thickened with sub-valvular deformity and aortic valve was tricuspid and normal. The left main and right coronary arteries were seen to arise from respective aortic sinuses. The left main coronary artery (LMCA) (marked with ‘*’ in Figure 1) had a long course with the first lateral branch supplying the territory corresponding to obtuse marginal artery (basal anterolateral and inferolateral segments). Left circumflex artery (LCx) originated from this artery with ‘recurrent course’ along the LMCA (black arrow in the Figure 1) to the proximal left atrio-ventricular groove. There were no other segments of severe angulation. This pattern of origin and course of LCx could be described as a ‘recurrent’ course of left circumflex artery and has not been described previously in literature. Such segments of severe angulation have altered flow dynamics and may be prone to development of spontaneous arterial dissections and acute coronary events. Segments of such tortuosity also pose difficulties during interventional procedures while introducing sheaths and stents.
Reverse lateral upper arm flaps for treating large soft tissue defects extending from the elbow to the forearm
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
Hideki Okamoto, Yohei Kawaguchi, Shinji Miwa, Hisaki Aiba, Hiroya Senda, Satona Murakami, Kazuo Hayakawa, Yuji Joyo, Hideki Murakami, Hiroaki Kimura
When a lateral upper arm flap is taken, the anterior or posterior radial collateral arteries are raised as a pedicle. Song et al. [10] and Katsaros et al. [9] raised the anterior radial collateral artery and posterior radial collateral artery as pedicles, respectively. In 1986, Maruyama and Takeuchi [1] first reported a reverse lateral upper arm flap using a radial recurrent artery. Subsequently, Culbertson and Mutimer [2] described a reverse lateral upper arm flap using the interosseous recurrent artery. Martin et al. [11] and Casoli et al. [12] reported an extended lateral upper arm flap that extended up to the distal forearm and wrist. Morrison et al. [4] reported a two-stage reverse lateral upper arm flap based on the radial recurrent artery for coverage of complex traumatic elbow injuries. Herein, the authors elevated the flap and reinset it in its native position and sutured at the skin level. After at least 15 days, the flap was transferred to the elbow wound being treated. Ashfaq et al. [5] used at the reverse lateral upper arm flap to cover elbow defects caused due to burns. The flap sizes ranged from 9 × 5 cm to 15 × 6 cm, and the fasciocutaneous distal base was left intact [5]. In our cases, we implanted a reverse lateral upper arm flap using the interosseous recurrent artery. We succeeded in preserving the retrograde blood flow from the interosseous recurrent artery and covering large skin defects around the elbow and forearm by using a reverse lateral upper arm flap to create a pedicled flap, as described in the reports by Ashfaq et al. [5] and di Summa et al. [13], instead of an island flap. A skin bridge was maintained over the pedicle at the distal margin of the flap to improve the venous drainage in all cases.