Discover the most talked about and latest scientific content & concepts.

Concept: Anatomical snuff box


To demonstrate the feasibility of distal left transradial approach for patients in whom left radial access is preferred over right radial access for coronary angiography and interventions. This procedure is more convenient for the operator. For the right- handed patient, left radial access is more convenient because of the free use of the right hand after the procedure. In addition, this technique reduces the chance for radial artery occlusion at the site of the distal forearm.

Concepts: Right-wing politics, Left-wing politics, Hand, Atherosclerosis, Radial artery, Forearm, Atheroma, Anatomical snuff box


Distal transradial access in the anatomical snuffbox has advantages over standard access in terms of patient and operator comfort levels and risk of ischemia. Radial artery preservation could be a relevant issue in patients requiring multiple radial artery procedures and coronary bypass with the use of a radial graft. One relevant drawback is the challenging puncture of a small and weak artery, with a steeper learning curve.

Concepts: Coronary artery bypass surgery, Radial artery, Anatomical snuff box


Polydactyly is one of the most common congenital hand deformities managed by orthopaedic surgeons. It is most often found in isolation; however, rarely, it may be associated with genetic syndromes. Polydactyly is classified as postaxial, preaxial, or central depending on the radioulnar location of the duplicated digits. Postaxial polydactyly, which affects the ulnar side of the hand, is most common and is typically managed with excision or suture ligation of the supernumerary digit. Preaxial polydactyly, which affects the thumb or radial side of the hand, often requires reconstructive techniques to ensure a functional, stable thumb. Central polydactyly is much less common, and reconstruction can be challenging.

Concepts: Hand, Polydactyl cat, Dorsal interossei of the hand, Anatomical snuff box, Ulnar nerve, Polydactyly, Finger


Intra-target microdosing (ITM) is a novel drug development approach aimed at increasing the efficiency of first-in-human (FIH) testing of new molecular entities (NMEs). ITM combines intra-target drug delivery and “microdosing,” the subpharmacological systemic exposure. We hypothesized that when the target tissue is small (about 1/100th of total body mass), ITM can lead to target therapeutic-level exposure with minimal (microdose) systemic exposure. Each of five healthy male volunteers received insulin microdose into the radial artery or full therapeutic dose intravenously in separate visits. Insulin and glucose levels were similar between systemic administration and ITM administration in the ipsilateral hand, and glucose levels demonstrated a reduction in the ipsilateral hand but not in the contralateral hand. Positron emission tomography (PET) imaging of (18) F-fluorodeoxyglucose (FDG) uptake demonstrated differences between the ipsilateral and contralateral arms. The procedures were safe and well-tolerated. Results are consistent with ITM proof-of-concept (POC) and demonstrate the ethical, regulatory, and logistical feasibility of the approach.

Concepts: Carbon-11, Anatomical snuff box, Fluorine-18, Positron emission, Positron, Pharmacology, Proof of concept, Positron emission tomography


Angioplasty on the radial artery have been performed with good success rates in patients with critical hand ischemia. We sought to assess the feasibility and safety of radial angioplasty on complex radial access in patients undergoing coronary angiography.

Concepts: Cardiovascular system, Anatomical snuff box, Forearm, Radial artery, Angina pectoris, Cardiology, Atheroma, Atherosclerosis


This study was intended to confirm whether simultaneous examination of surface and volume models contributes to learning of hand structures. Outlines of the skin, muscles, and bones of the right hand were traced in sectioned images of a male cadaver to create surface models of the structures. After the outlines were filled with selected colors, the color-filled sectioned images were stacked to produce a volume model of the hand, from which the skin was gradually peeled. The surface models provided locational orientation of the hand structures such as extrinsic and intrinsic hand muscles, while the peeled volume model revealed the depth of the individual hand structures. In addition, the characteristic appearances of the radial artery and the wrist joint were confirmed. The exploration of the volume model accompanied by equivalent surface models is synergistically helpful for understanding the morphological properties of hand structures.

Concepts: Surface, Dorsal interossei of the hand, Trapezium, Anatomical snuff box, Hand strength, Lunate bone, Hand, Forearm


Pseudoaneurysm of the radial artery is extremely rare. It usually occurs secondary to trauma, interventional procedures, and infections. Symptoms occur either due to mass effect by the pseudoaneurysm, digital ischemia or nerve suppression. B-mode and color Doppler US are the first choice in diagnosis. The pathognomonic ultrasound sign of pseudoaneurysm is the turbulent flow, which is called the “ying-yang” sign. Bandages, ultrasound probe compression, ultrasound-guided thrombin injection, covered stents, and surgical ligation can be be used in treatment. In here, we present the case of a 28-year-old woman who developed a radial artery pseudoaneurysm after a stabbing injury in her hand and discuss the radiological and treatment options.

Concepts: Fundamental physics concepts, Viscosity, Dorsal interossei of the hand, Fluid dynamics, Anatomical snuff box


Distal radial artery aneurysms of the hand are rare. We herein report a rare case of radial artery aneurysm in the anatomical snuff box.

Concepts: Dorsal interossei of the hand, Atherosclerosis, Radial artery, Anatomical snuff box


Three decades ago, pedicled flaps from the groin and abdomen were the workhorses in hand and forearm reconstruction. These pedicled flaps have several disadvantages including patient discomfort, stiffness, the need for flap division, and the inability to elevate the hand after acute trauma. Hence it is not surprising that free flap reconstruction has become the method of choice in coverage of complex hand and forearm defects. Despite this, pedicled flaps may still be indicated in the current era of microsurgery. Based on a review of the literature and the author’s experience, the current review defines these indications as follows: complex defects in children aged less than 2 years; coverage of digital stump defects in preparation for toe-to-hand transfer; high-voltage electric burns with the hand surviving on collateral blood supply; salvage of the thumb ray in high-voltage electric burns with concurrent thrombosis of the radial artery; mutilating hand injuries; length preservation of multiple digital amputations in manual workers; and multiple defects within the digits, hand, or forearm. These indications are discussed along with clinical examples.

Concepts: Dorsal interossei of the hand, Surgery, Heart, Anatomical snuff box, Forearm, Electricity, Radial artery, Blood


Radial artery occlusion (RAO) is the most common complication of the transradial approach (TRA) to cardiac catheterization, with a reported incidence between 0.8 % and 30 %. RAO is likely the result of acute thrombus formation and complicated by neointimal hyperplasia. Most RAO are asymptomatic with rare cases of acute hand or digit ischemia reported in the literature. The role of testing for dual circulation to the hand in determining the safety of TRA as it relates to symptomatic RAO is controversial; however, modifiable risk factors like low sheath-to-artery ratio, adequate anticoagulation, and non-occlusive (“patent”) hemostasis are likely to prevent RAO. This review examines the incidence of RAO, potential mechanisms leading to RAO, and strategies to prevent and treat RAO.

Concepts: Pulse, Anatomical snuff box, Blood, Heart, Blood vessel, Thrombosis, Myocardial infarction, Thrombus