ARTERIA TIBIALIS ANTERIOR'UN MORFOMETRİK VE MORFOLOJİK DEĞERLENDİRİLMESİ

Year 2023, Volume: 86 Issue: 4, 360 - 367, 01.12.2023

Buse Naz Çandır , Özcan Gayretli , İlke Ali Gürses , Osman Coşkun , Latif Sağlam , Adnan Öztürk , Ayşin Kale

https://doi.org/10.26650/IUITFD.1266936

Abstract

Amaç: Arteria (a.) tibialis anterior anatomisi ile ilgili yapılmış çalışmalar ağırlıklı olarak arter morfolojisine odaklanmıştır. Arterin morfometrisini inceleyen sınırlı sayıda çalışma bulunmaktadır. Bu doğrultuda, arter morfolojisi ve morfometrisini ayrıntılı olarak incelemeyi amaçladık.
Gereç ve Yöntem: Çalışma renkli silikon enjekte edilen 30 alt ekstremite üzerinde gerçekleştirildi. A. tibialis anterior'un ve a. poplitea'nın morfolojik özellikleri değerlendirildi. Truncus tibiofibularis'in uzunluğu, a. poplitea, a. tibialis anterior, a. tibialis posterior, a. fibularis ve a. dorsalis pedis'in çapları ile a. tibialis anterior'un orijin yerinin caput fibulae’ya ve tuberositas tibiae'ye vertikal uzaklığı morfometrik olarak incelendi.
Bulgular: A. tibialis anterior'un dallanma morfolojisi, yeri ve seyrine göre beş tipi belirlendi. Truncus tibiofibularis'in ortalama uzunluğu 32,0±9,9 mm idi. A. poplitea, a. tibialis anterior, a. tibialis posterior, a. fibularis ve a. dorsalis pedis'in ortalama çapları sırasıyla 5,8±1,0 mm, 4,1±0,6 mm, 3,5±0,6 mm, 3,7±0,7 mm ve 2,8±0,4 mm olarak bulundu. A. tibialis anterior'un orijin yerinin caput fibulae’ye vertikal uzaklığı ortalama 38±10,2 mm; tuberositas tibiae'ye mesafesi ise ortalama 23,6±8,0 mm olarak ölçüldü.
Sonuç: A. tibialis anterior'un anatomisini ve a. poplitea'dan dallanma varyasyonlarını bilmek; diz çevresindeki endovasküler girişimler, periferik arter hastalığı için planlanan infrapopliteal bypass, ve tibial platoyu ilgilendiren ortopedik operasyonlar açısından oldukça önemlidir. Elde ettiğimiz sonuçların ortopedik ve vasküler cerrahlara yardımcı olacağı düşüncesindeyiz.

Keywords

Arteria poplitea, arteria tibialis anterior, truncus tibiofibularis, arteria tibialis posterior, arteria fibularis

Project Number

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MORPHOMETRIC AND MORPHOLOGIC EVALUATION OF ANTERIOR TIBIAL ARTERY

Abstract

Objective: Previous studies related to the anatomy of the anterior tibial artery have focused mainly on morphology. The number of studies examining arterial morphometry is limited. Consequently, we aimed to examine the morphology and morphometry of this artery in detail.
Material and Method: The study was performed on 30 lower extremities injected with colored silicone. Morphological features of anterior tibial and popliteal arteries were assessed. The morphometrical evaluation included the tibiofibular trunk length, diameters of popliteal, anterior tibial, posterior tibial, fibular, dorsalis pedis arteries, and the vertical distances between the origin of the anterior tibial artery and the head of the fibula and tibial tuberosity.
Result: Five types of the anterior tibial artery were determined according to branching morphology, location, and course. The mean length of the tibiofibular trunk was 32.0±9.9 mm. Mean diameters of popliteal, anterior tibial, posterior tibial, fibular, and dorsalis pedis arteries were 5.8±1 mm, 4.1±0.6 mm, 3.5±0.6 mm, 3.7±0.7 mm and 2.8± 0.4 mm, respectively. The mean vertical distance of the origin of the tibialis anterior artery to the head of the fibula and tibial tuberosity was 38±10.2 mm and 23.6±8.0 mm, respectively.
Conclusion: Knowledge regarding anterior tibial artery anatomy and popliteal artery branching variations are essential for endovascular interventions around the knee, infrapopliteal bypass procedures planned for peripheral arterial disease, and orthopedic operations involving the tibial plateau. We believe that our results will help orthopedic and vascular surgeons.

Keywords

Popliteal artery, anterior tibial artery, tibiofibular trunk, posterior tibial artery, fibular artery

Supporting Institution

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Project Number

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Thanks

The authors sincerely thank those who donated their bodies to science so that anatomical research could be performed.

References

• 1. Olewnik t, Labçtowicz P, Podgorski M, Polguj M, Ruzik K, Topol M. Variations in terminal branches of the popliteal artery: cadaveric study. Surg Radiol Anat 2019;41(12):1473-82. [CrossRef] google scholar
• 2. Day CP, Orme R. Popliteal artery branching patterns -- an angiographic study. Clin Radiol 2006;61(8):696-9. [CrossRef] google scholar
• 3. FIPAT. Terminologia Anatomica. 2nd ed. FIPAT.library.dal. ca. Federative International Programme for Anatomical Terminology, 2019. google scholar
• 4. Li Z, Yu A, Qi B, Pan Z, Ding J. Flow-through free fibula osteocutaneous flap in reconstruction of tibial bone, soft tissue, and main artery segmental defects. Ann Plast Surg 2017;79(2):174-9. [CrossRef] google scholar
• 5. Sanan A, Abdel Aziz KM, Janjua RM, van Loveren HR, Keller JT. Colored silicone injection for use in neurosurgical dissections: anatomic technical note. Neurosurgery 1999;45(5):1267-74. [CrossRef] google scholar
• 6. Heidari N, Lidder S, Grechenig W, Tesch NP, Weinberg AM. The risk of injury to the anterior tibial artery in the posterolateral approach to the tibia plateau: a cadaver study. J Orthop Trauma 2013;27(4):221-5. [CrossRef] google scholar
• 7. Senior HD. The development of the arteries of the Human lower Extremity. Am J Anat 1919;25(1):55-95. [CrossRef] google scholar
• 8. Standring S, editor. Gray’s Anatomy. The Anatomical Basis of Clinical Practice. 41st ed. London: Elsevier; 2016.p.1412-1416. google scholar
• 9. Rohan A, Domagala Z, Abu Faraj S, Korykowska A, Klekowski J, Pospiech N, et al. Branching patterns of the foetal popliteal artery. Folia Morphol (Warsz) 2019;78(1):71-8. google scholar
• 10. Tindall AJ, Shetty AA, James KD, Middleton A, Fernando KW. Prevalence and surgical significance of a high-origin anterior tibial artery. J Orthop Surg (Hong Kong) 2006;14(1):13-6. [CrossRef] google scholar
• 11. May H, Kastan O, Emre TY, Cetin M, Unal M, Kose O. Anterior tibial artery and its clinical importance in the posterolateral approach to the tibial plateau: an angiographic study on 219 lower limbs. J Knee Surg 2022;35(7):725-30. [CrossRef] google scholar
• 12. Hall HA, Minc S, Babrowski T. Peripheral artery aneurysm. Surg Clin North Am 2013;93(4):911-23. [CrossRef] google scholar
• 13. Hölzle F, Ristow O, Rau A, Mücke T, Loeffelbein DJ, Mitchell DA, et al. Evaluation of the vessels of the lower leg before microsurgical fibular transfer. Part I: anatomical variations in the arteries of the lower leg. Br J Oral Maxillofac Surg 2011;49(4):270-4. [CrossRef] google scholar
• 14. Ozgur Z, Ucerler H, Aktan Ikiz ZA. Branching patterns of the popliteal artery and its clinical importance. Surg Radiol Anat 2009;31(5):357-62. [CrossRef] google scholar
• 15. Gautam A, Sintakala C. Anatomical study of dorsalis pedis artery. Journal of Chitwan Medical College 2020;10(31):24-6. [CrossRef] google scholar
• 16. Moore KL, Dalley AF, Agur AMR, editors. Clinical oriented anatomy. 4th ed. Philadelphia: Lippincott Williams & Wilkins;1999.p.60-74. google scholar
• 17. Adachi B. Das Arteriensystem der Japaner, Vol II. Maruzen: Kyoto; 1928. google scholar
• 18. Celtikci P, Ergun O, Durmaz HA, Conkbayir I, Hekimoglu B. Evaluation of popliteal artery branching patterns and a new subclassification of the ‘usual’ branching pattern. Surg Radiol Anat 2017;39(9):1005-15. [CrossRef] google scholar
• 19. Kim D, Orron DE, Skillman JJ. Surgical significance of popliteal arterial variants. A unified angiographic classification. Ann Surg 1989;210(6):776-81. [CrossRef] google scholar
• 20. Lippert H, Pabst R. Arterial variations in man: classification and frequency. Munchen: J.F. Bergmann Verlag; 1985. [CrossRef] google scholar
• 21. Kil SW, Jung GS. Anatomical variations of the popliteal artery and its tibial branches: analysis in 1242 extremities. Cardiovasc Intervent Radiol 2009;32(2):233-40. [CrossRef] google scholar
• 22. Piral T, Germain M, Princ G. Absence of the posterior tibial artery: implications for free transplants of the fibula. Surg Radiol Anat 1996;18(2):155-8. [CrossRef] google scholar
• 23. Atanasova M, Georgiev GP, Jelev L. Intriguing variations of the tibial arteries and their clinical implications. Int J Anat Var 2011;4:45-7. google scholar