A cadaveric study of fibular (peroneal) artery continuing as dorsalis pedis artery associated with hypoplastic anterior tibial artery and its developmental basis

2018 ◽  
Vol 67 ◽  
pp. S32
Author(s):  
S.J. Fernandes ◽  
A.L. Singh ◽  
R. Bhat ◽  
P. Shetty
Keyword(s):  
Cadaveric Study ◽  
Peroneal Artery ◽  
Anterior Tibial Artery ◽  
Tibial Artery ◽  
Dorsalis Pedis Artery ◽  
Anterior Tibial

scholarly journals A morphological study on variation in branching pattern of dorsalis pedis artery and its clinical perspectives

2020 ◽  
Vol 7 (10) ◽  
pp. 1594
Author(s):  
B. Vengadesan
Keyword(s):  
Peroneal Artery ◽  
Lateral Side ◽  
Anterior Tibial Artery ◽  
Branching Pattern ◽  
Text Book ◽  
Classical Text ◽  
Medical College ◽  
Tibial Artery ◽  
Dorsalis Pedis Artery ◽  
Anterior Tibial

Background: The study of dorsalis pedis artery and variations in its branching pattern has been reported sporadically. The purpose of this study was to evaluate the arterial. Supply on the dorsum of the foot. Methods: The study was carried out of forty dissected limbs of unknown sex and age from the department of Anatomy, Aarupadai veedu Medical College, Pondicherry.Results and Discussion: The incidence of classical text-book description was found to be very less in present study. In 5% of cases the dorsalis pedis artery was replaced by the peroneal artery. In 5% of cases the anterior tibial artery was found on lateral side of leg, dorsalis pedis artery is a continuation of the anterior tibial artery seen passing above lateral malleolus and then it passes forwards along the lateral side of the dorsum of the foot.Conclusion: The findings suggest that the lateral aspect of the dorsum of the foot has a poor nourishment. 

scholarly journals Cadaveric Study of Angiosomes of Anterior Tibial and Dorsalis Pedis Artery

2018 ◽  
Vol 35 (01) ◽  
pp. 17-24
Author(s):  
V. Paranjape ◽  
J. Kulkarni ◽  
P.V. Swamy ◽  
S. Shevade
Keyword(s):  
Peroneal Artery ◽  
Anterior Tibial Artery ◽  
Branching Pattern ◽  
Arterial Tree ◽  
Tibial Artery ◽  
Dorsalis Pedis Artery ◽  
Doppler Study ◽  
Anterior Tibial ◽  
Peripheral Pulse ◽  
Arcuate Artery

Introduction Angiosome formed by Anterior tibial artery and dorsalis pedis artery supply the ankle and the dorsum of foot. Both the vessels shows variation in termination and branching pattern. Materials and Methods 50 free formalin preserved limbs were dissected for the study. Results and Conclusion Anterior tibial artery showed variation in termination in 16%, most common of them was formation of loop with perforating branch of peroneal artery in 10%, bifurcation in to medial and lateral tarsal artery in 4% and trifutcation in 2%. Branching pattern of dorsalis pedis artey was variable in 18%, medial and lateral tarsal arteries were not branches of dorsalis pedis artery in 14% and 16% respectively. Arcuate artery was absent in 10%, when present it was branch of dorsalis pedis artery in 96%, perforating branch of peroneal artery in 2% and loop of medial and lateral tarsal artery in 2%. First dorsal metatarsal artery was not branch of dorsalis pedis artery in 4%. Lateral tarsal artery was constantly found in all the dissected limbs. Thorough knowledge of variation about branching pattern of arterial tree is clinically important for accuracy in interpretation of angiographs, Doppler study of lower limb vessels and optimum use of vascular pedicle for myocutaneous flaps. Importance of palpation of peripheral pulse in lateral tarsal artery is discussed in the study.

Examination of the Origin and Branching Direction of the Anterior Medial Malleolar Artery From the Anterior Tibial Artery: A Cadaveric Study

2018 ◽  
Vol 12 (2) ◽  
pp. 167-171 ◽  
Author(s):  
Ichiro Tonogai ◽  
Fumio Hayashi ◽  
Yoshihiro Tsuruo ◽  
Koichi Sairyo
Keyword(s):  
Ankle Joint ◽  
Sagittal Plane ◽  
External Iliac Artery ◽  
Longitudinal Axis ◽  
Cadaveric Study ◽  
Ankle Arthroscopy ◽  
Anterior Tibial Artery ◽  
Tibial Artery ◽  
Anterior Tibial ◽  
Branching Point

Background. This study characterized the anterior medial malleolar artery (AMMA) branching from the anterior tibial artery (ATA) to identify problems in anterior ankle arthroscopy possibly contributing to injury to the AMMA. Methods. Barium was injected into 12 adult cadaveric feet via the external iliac artery and the origin and branching direction of the AMMA were identified on computed tomography. Results. The AMMA originated from the level of the ankle joint and below and above the ankle joint line (AJL) in 4 (33.3%), 6 (50.0%), and 1 (8.3%) specimen, respectively. Mean distance from the AJL to the branching point of the AMMA on the sagittal plane was 2.5 mm distal to the AJL. Mean angle between the distal longitudinal axis of the ATA and AMMA was 83.2°. Conclusions. This study established the origin and branching of the AMMA from the ATA. The AMMA should be examined carefully during ankle arthroscopy. Levels of Evidence: Level IV: Cadaveric study

scholarly journals Ultrasound in diagnosis of anatomical variation of anterior and posterior tibial arteries.

2016 ◽  
Vol 18 (1) ◽  
pp. 64 ◽  
Author(s):  
Miao Zheng ◽  
Chuang Chen ◽  
Qianyi Qiu ◽  
Changjun Wu
Keyword(s):  
Anatomical Variation ◽  
Posterior Tibial Artery ◽  
Peroneal Artery ◽  
Medial Malleolus ◽  
Anterior Tibial Artery ◽  
Tarsal Tunnel ◽  
Posterior Tibial ◽  
Tibial Artery ◽  
Tibial Arteries ◽  
Anterior Tibial

Aims: Knowledge about branching pattern of the popliteal artery is very important in any clinical settings involving the anterior and posterior tibial arteries. This study aims to elucidate the anatomical variation patterns and common types of anterior tibial artery (ATA) and posterior tibial arteries (PTA) in the general population in China. Material and methods: Anatomical variations of ATA, PTA, and peroneal artery were evaluated with ultrasound in a total of 942 lower extremity arteries in 471 patients. Results: Three patterns of course in the PTA were ultrasonographically identified:  1) PTA1: normal anatomy with posterior tibial artery entering tarsal tunnel to perfuse the foot (91.5%),  2) PTA2: tibial artery agenetic, and replaced by communicating branches of peroneal artery entering tarsal tunnel above the medial malleolus to perfuse the foot (5.9%), and 3) PTA3: hypoplastic or aplastic posterior tibial artery communicating above the medial malleolus with thick branches of peroneal artery to form a common trunk entering into the tarsal tunnel (2.4%). In cases where ATA  was hypoplastic or aplastic, thick branches of the peroneal artery replaced the anterior tibial artery to give rise to dorsalis pedis artery, with a total incidence of 3.2 % in patients, and were observed more commonly in females than in males. Hypoplastic or aplastic termini of ATA and PTA, with perfusion of the foot solely by the peroneal artery, was identified in 1 case. In another case, both communicating branches of the peroneal artery and PTA entered the tarsal tunnel to form lateral and medial plantar arteries.Conclusions: Anatomical variation of ATA and PTA is relatively common in the normal population. Caution should be exercised with these variations when preparing a peroneal artery vascular pedicle flap grafting. Ultrasound evaluation provides accurate and reliable information on the variations.

scholarly journals Effects of Enhanced External Counterpulsation With Different Sequential Levels on Lower Extremity Hemodynamics

2021 ◽  
Vol 8 ◽  
Author(s):  
Yahui Zhang ◽  
Yujia Zhang ◽  
Yinfen Wang ◽  
Xiuli Xu ◽  
Jing Jin ◽  
...  
Keyword(s):  
Blood Flow ◽  
Flow Velocity ◽  
Posterior Tibial Artery ◽  
Anterior Tibial Artery ◽  
Posterior Tibial ◽  
Tibial Artery ◽  
Dorsalis Pedis Artery ◽  
Level Sequence ◽  
Anterior Tibial ◽  
Enhanced External Counterpulsation

Objective: This study aimed to investigate acute hemodynamics of lower extremities during enhanced external counterpulsation with a three-level sequence at the hips, thighs, and calves (EECP-3), two-level sequence at the hips and thighs (EECP-2), and single leg three-level sequence (EECP-1).Methods: Twenty healthy volunteers were recruited in this study to receive a 45-min EECP intervention. Blood flow spectrums in the anterior tibial artery, posterior tibial artery, and dorsalis pedis artery were imaged by Color Doppler ultrasound. Mean flow rate (FR), area, pulsatility index (PI), peak systolic velocity (PSV), end-diastolic velocity (EDV), mean flow velocity (MV), and systolic maximum acceleration (CCAs) were sequentially measured and calculated at baseline during EECP-3, EECP-1, and EECP-2.Results: During EECP-3, PI, PSV, and MV in the anterior tibial artery were significantly higher, while EDV was markedly lower during EECP-1, EECP-2, and baseline (all P < 0.05). Additionally, ACCs were significantly elevated during EECP-3 compared with baseline. Moreover, FR in the anterior tibial artery was significantly increased during EECP-3 compared with baseline (P = 0.048). During EECP-2, PI and MV in the dorsalis pedis artery were significantly higher and lower than those at baseline, (both P < 0.05). In addition, FR was markedly reduced during EECP-2 compared with baseline (P = 0.028). During EECP-1, the area was significantly lower, while EDV was markedly higher in the posterior tibial artery than during EECP-1, EECP-2, and baseline (all P < 0.05). Meanwhile, FR of the posterior tibial artery was significantly reduced compared with baseline (P = 0.014).Conclusion: Enhanced external counterpulsation with three-level sequence (EECP-3), EECP-2, and EECP-1 induced different hemodynamic responses in the anterior tibial artery, dorsalis pedis artery, and posterior tibial artery, respectively. EECP-3 acutely improved the blood flow, blood flow velocity, and ACCs of the anterior tibial artery. In addition, EECP-1 and EECP-2 significantly increased the blood flow velocity and peripheral resistance of the inferior knee artery, whereas they markedly reduced blood flow in the posterior tibial artery.

scholarly journals Pseudoaneurysm of the Perforating Peroneal Artery following Ankle Arthroscopy

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Ichiro Tonogai ◽  
Eiki Fujimoto ◽  
Koichi Sairyo
Keyword(s):  
Ankle Joint ◽  
Vascular Complications ◽  
Posterior Tibial Artery ◽  
Ankle Arthroscopy ◽  
Peroneal Artery ◽  
Anterior Tibial Artery ◽  
Foot And Ankle ◽  
Posterior Tibial ◽  
Tibial Artery ◽  
Anterior Tibial

The use of standard anterolateral and anteromedial portals in ankle arthroscopy results in reduced risk of vascular complications. Anatomical variations of the arterial network of the foot and ankle might render the vessels more susceptible to injury during procedures involving the anterior ankle joint. The literature, to our knowledge, reports only one case of a pseudoaneurysm involving the peroneal artery after ankle arthroscopy. Here, we report the unusual case of a 48-year-old man in general good health with the absence of the anterior tibial artery and posterior tibial artery. The patient presented with a pseudoaneurysm of the perforating peroneal artery following ankle arthroscopy for traumatic osteoarthritis associated with nonunion of the medial malleolus. The perforating peroneal artery injury was repaired by performing end-to-end anastomosis. The perforating peroneal artery is at higher risk for iatrogenic injury during ankle arthroscopy in the presence of abnormal arterial variations of the foot and ankle, particularly the absence of the anterior tibial artery and posterior tibial artery. Before ankle arthroscopy, surgeons should therefore carefully observe the course of the perforating peroneal artery on enhanced 3-dimensional computed tomography, especially in patients with a history of trauma to the ankle joint.

Quantitative and Qualitative Assessment of the Relative Arterial Contributions to the Calcaneus

2018 ◽  
Vol 39 (5) ◽  
pp. 604-612 ◽  
Author(s):  
Johanna C. E. Donders ◽  
Craig E. Klinger ◽  
Andre D. Shaffer ◽  
Lionel E. Lazaro ◽  
Ryan R. Thacher ◽  
...  
Keyword(s):  
Posterior Tibial Artery ◽  
Quantitative Mri ◽  
Peroneal Artery ◽  
Anterior Tibial Artery ◽  
Soft Tissue Envelope ◽  
Posterior Tibial ◽  
Tibial Artery ◽  
Contrast Enhanced ◽  
Entry Points ◽  
Anterior Tibial

Background: The purpose of this study was to quantitatively and qualitatively assess relative arterial contributions to the calcaneus. Method: Fourteen cadaveric ankle pairs were used. In each specimen, the posterior tibial artery, peroneal artery, and anterior tibial artery were cannulated and used for contrast-enhanced magnetic resonance imaging (MRI) and computed tomography (CT). Quantitative MRI analysis of the pre- and postcontrast MRI scans facilitated assessment of relative arterial contributions. In addition, postcontrast MRIs were used to measure all perfused arterial entry points and scaled to a 3-dimensional calcaneus model. Contrast-enhanced CT imaging was assessed to further delineate the extraosseous arterial course. Two pairs underwent infusion of diluted BaSO4 through a constant-pressure pump using extended infusion duration. Results: Quantitative MRI findings indicated the peroneal artery provided 52.6% of the calcaneal arterial supply, 31.6% from the posterior tibial artery, and 15.8% from the anterior tibial artery. The cortical entry points were found in fairly consistent patterns along calcaneal cortical surfaces. All specimens demonstrated intraosseous anastomoses between lateral and medial entry points at common locations. Conclusions: The peroneal artery was found to provide the largest calcaneal arterial contribution, followed by the posterior tibial artery and anterior tibial artery. A rich anastomotic arterial network was found supplying the calcaneus. Clinical Relevance: This study provides quantitative and qualitative findings of the relative arterial contribution of the calcaneus. This knowledge can help expand our understanding of calcaneal vascularization, demonstrate the vascular impact of calcaneal fracture and surgery, and facilitate future research on the arterial anatomy of the calcaneal soft tissue envelope.

Collateral circulation between angiosomes in the feet of diabetic patients

Vascular ◽  
2018 ◽  
Vol 26 (4) ◽  
pp. 432-439 ◽  
Author(s):  
Erkan Orhan ◽  
Ömer Özçağlayan
Keyword(s):  
Collateral Circulation ◽  
Posterior Tibial Artery ◽  
Artery Occlusion ◽  
Peroneal Artery ◽  
Diabetic Patients ◽  
Anterior Tibial Artery ◽  
Posterior Tibial ◽  
Tibial Artery ◽  
Anterior Tibial ◽  
Tibial Artery Occlusion

Objectives The main factor in the healing of foot ulcers in diabetic patients is adequate perfusion. There is no consensus on whether direct or indirect revascularization is more effective in leg revascularization. At the centre of that debate, there is a disagreement about whether collateral circulation is sufficient or not. Our aim is to evaluate collateral circulation activity between angiosomes in the feet of diabetic patients by evaluating the level of occlusion in leg arteries and comparing the angiosome regions that have necrosis. Methods The study included 61 patients. All had undergone CT angiography to the lower extremity prior to any revascularization of the leg arteries between September 2014 and September 2016. Stenosis was evaluated on the anterior tibial artery, the posterior tibial artery and the peroneal artery up to the level of the ankle. The opening of the vessel wall at the narrowest part of the vessel was determined as a percentage. The areas with necrosis were determined according to the angiosomes of the posterior tibial artery, anterior tibial artery and peroneal artery vessels. Results Necrosis of the foot was most common in the posterior tibial artery angiosome. Necrosis in the posterior tibial artery angiosome was independent of the level of posterior tibial artery occlusion; however, it was associated with the occlusion of the anterior tibial artery ( p < 0.05). It was found that anterior tibial artery occlusion over 15% resulted in necrosis in the posterior tibial artery angiosome. Conclusions Collateral circulation between the anterior tibial artery and posterior tibial artery is active and there is almost always occlusion in the posterior tibial artery branches. The posterior tibial artery angiosome is fed by the collateral arteries of the anterior tibial artery even if there is no occlusion of posterior tibial artery at the level of the leg, so indirect revascularization on the anterior tibial artery is sufficient to provide foot circulation.

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