Title: Posterior Tibial Artery, its Branching Pattern and Variations with its Clinical Applications.
Abstract: The present study about the posterior tibial artery was carried out in both
adult and foetal cadaveric specimens and clinical cases. The results of the
study are based on the routine dissection method, radiological method, clinical
studies and histological studies.
Origin of posterior tibial artery from popliteal artery at the lower border
of popliteus was observed in 86% and above the lower border of popliteus in
6%,below the lower border of popliteus muscle in 2% and absence of posterior
tibial artery in 6%. The knowledge of variations in the level of origin of
posterior tibal artery will help the Radiologists for interventional management
of tibial and peroneal diseases.
The branches of posterior tibial artery - the circumflex fibular artery,
nutrient artery of tibia, peroneal artery, muscular branches, perforating
branches, communicating branch, medial malleolar branches, calcaneal
branches and terminal branches were observed in the present study.
The posterior tibial artery terminated by dividing into medial lateral
plantar arteries was observed in 86% , terminated at a higher level by giving
smaller branches to the skin and muscles in 4% and terminated by joining with
peroneal artery in 4% of cases. The posterior tibial artery was completely
replaced by peroneal artery in 6% cases. Observations about the occurrence of
rare and abnormal termination of posterior tibial artery and replacement of
posterior tibial artery by peroneal artery will definitely serve the vascular
surgeons in the field of revascularization surgery for foot salvage. Through
more aggressive use of tibial bypass, limb preservation has improved greatly.
The perforating branches from posterior tibial artery were located only
in the middle two quarters of leg in 92.5% of cases and these branches were
located in the proximal, middle and distal third of the leg in 7.5% of cases. The
observations about the perforating branches of posterior tibial artery will help
the plastic surgeons in refinements in lower extremity free flap reconstructive
surgery.
The peroneal artery arose from the posterior tibial artery in 94% and
directly from the popliteal artery in the absence of posterior tibial artery in 6%.
The distance of origin of peroneal artery from the commencement of posterior
tibial artery was varied from 2cms to 7.2 cms. In 8% of cases, the peroneal
artery was enlarged in size and replaced the posterior tibial artery in the distal
part of the leg. The information about the distance of origin of peroneal artery
and its termination, replacement of posterior tibial artery by peroneal artery in
the entire leg will alert the general and vascular surgeons because the peroneal
artery is an important vessel to consider for use in limb revascularization and
salvage in the absence of a suitable popliteal artery.
Accessibility to the leg arteries is a critical factor in achieving
successful revascularization. So, this study of posterior tibial artery, its
branching pattern and variations will definitely be of use to the anatomists, and
clinicians of the respective fields in the future.
Publication Year: 2008
Publication Date: 2008-03-01
Language: en
Type: dissertation
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