Normal angiography of the upper extremity (DSA)

Normal angiography of the upper extremity (DSA)

Normal angiography of the upper extremity (DSA)


Introduction

This anatomical module of e-Anatomy is a vascular anatomy atlas of the upper extremity on a peripheral angiogram (Digital Subtraction Angiography - DSA).
We chose to create this module even though the catheter arteriography procedure of the upper extremity has become  less frequent  in modern practice, given the advancements in computed tomography/magnetic resonance angiography (CT/MRA). Indeed, catheter angiography continues to have major diagnostic and interventional roles in certain pathophysiological conditions such as trauma, acute limb ischemia, bypass graft planning, dialysis steal syndrome, vasculitis or vascular anomalies.
 

Material and methods

The images of this upper limb artery angiography are from the  left upper extremity of an abnormal patient, a 50-year-old woman with thromboangiitis obliterans, severe secondary Raynaud’s phenomenon and digital ischemia  resulting in gangrene of her left thumb and index finger.
After a right femoral puncture, a 100 cm 4 F angled catheter (Vertebral) was used to select the targeted subclavian artery. The subclavian arteriography was performed in the anteroposterior (AP) projection, at 7 mL/s injection rate for a total of 15 mL of contrast agent, and with two frames per seconds imaging acquisition. An arteriography of the remaining upper extremity was performed in multiple stations after catheterization of the brachial artery.
The proximal upper extremity arteries (subclavian, axillary, brachial, radial and ulnar arteries) were free of atherosclerosis, however, the distal angiography of the hand demonstrated numerous digital artery occlusions (all digits involved, but lesions predominant on I, II and IV) and incomplete palmar arches.
Note that the dorsal carpal arch (dorsal carpal anastomosis or network), the dorsal metacarpal arteries and the dorsal digital arteries of the hand were not visible on this angiogram.
The images were provided by Julien Frandon M.D. (Vascular radiology, Nîmes –  France). 
The arteries of these upper extremity angiography structures have been annotated by Antoine Micheau M.D. (Radiologist, Montpellier – France), according to the Terminologia Anatomica (TA2 – 2020).
 

 

There is no content here

  • Terminologia Anatomica 2 : https://fipat.library.dal.ca/ta2/
  • Netter, Frank H. (2011) Atlas of human anatomy /Philadelphia, PA : Saunders/Elsevier
  • Pocket Atlas of Human Anatomy: 5th edition - W. Dauber, Founded by Heinz Feneis