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Bilateral hypoplastic or aplastic posterior tibial artery

  • Rakesh K Varma;
    • Assistant Professor, Section of Interventional Radiology, Department of Radiology, University of Alabama at Birmingham, USA
  • Andrew J Gunn;
    • Assistant Professor, Section of Interventional Radiology, Department of Radiology, University of Alabama at Birmingham, USA
  • Nathan W Ertel;
    • Assistant Professor, Section of Interventional Radiology, Department of Radiology, University of Alabama at Birmingham, USA
  • Ahmed Kamel Abdel Aal
    • Associate Professor, Division of Interventional Radiology, Medical Director, Heart and Vascular Center, University of Alabama at Birmingham (UAB), USA

  • Corresponding Author(s): Rakesh K Varma

  • Assistant Professor, Section of Interventional Radiology, Department of Radiology, University of Alabama at Birmingham, USA

  • rvarma@uabmc.edu

  • +20-100-093-2140

  • Varma RK (2018).

  • This Article is distributed under the terms of Creative Commons Attribution 4.0 International License

Received : June 06, 2018
Accepted : July 18, 2018
Published Online : July 23, 2018
Journal : Journal of Case Reports and Medical Images
Publisher : MedDocs Publishers LLC
Online edition : http://meddocsonline.org

Cite this article: Varma RK, Gunn AJ, Ertel NW, Abdel Aal AK. Bilateral hypoplastic or aplastic posterior tibial artery. J Case Rep Clin Images. 2018; 1: 1005.

Description

      The popliteal and Peroneal Arteries (PR) arise from the sciatic artery (primary limb bud artery) whereas the Anterior Tibial (AT) and Posterior Tibial (PT) arise from the femoral artery. Being a derivative of the sciatic artery, PR is constant. Usually PR terminates above the ankle and divides into anterior or posterior communicating artery which anastomoses with the AT or PT respectively. Arrest in embryonic vascular development determines variations in popliteal artery branching patterns. In case of hypoplastic or aplastic PT {incidence is 0.8-3.8 %,} the PR is hypertrophied and either reinforces the PT below the ankle through perforators or replaces the PT and continues as the lateral plantar with medial plantar being absent. Probability of bilateral manifestation in people bearing this variation is upto 30%. Awareness of this variation is important while performing arterial reconstructions in femorodistal bypass graft procedures, during surgical clubfoot release or free fibular flap surgery.

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Figure 1: Preplanning free fibular flap surgery MIP coronals (1) & axial CTA images from the knees below at corresponding levels (2a,2b,2c) in a case oral cancer being evaluated for mandibular reconstruction demonstrating hypoplastic posterior tibial artery (arrowheads), enlarged peroneal artery (arrows) continuing as the lateral plantar artery.

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