An angiographic study of the anterior tibial artery in patients with aortoiliac occlusive disease

Abstract

The anterior tibial artery is of great clinical relevance to vascular infrapopliteal surgery. The sources (origins), length and luminal diameter of the anterior tibial artery in 46 men and 30 women with Lerich syndrome were studied by means of radiological and digital methods. The results obtained were described by twoway analysis of variance (Multi-group ANOVA) for unpaired data — the means for six subtypes with regard to sex and side of the body, using the STATISTICA 5.5 program. The anterior tibial artery occurred most frequently (92.11%) as a terminal branch of the popliteal artery in its normal (IA: 87.5 %, IB: 2.63%) and high (IIA 1: 1.32%, IIA 2: 0.66%) division. In the remainder (7.89%), the anterior tibial artery arose from both the anterior tibioperoneal trunks (IC: 1.97%, IIB: 5.92%). The statistical analysis of the sources of the anterior tibial artery did not show gender differences. Symmetry of the left and right popliteal patterns was observed in the two most frequent subtypes: IA (r₁ = 0.80) and IIB (r₂ = 0.83). The anterior tibial artery was the longest (p = 0.02 for men, p = 0.04 for women) in subtype IIA 2. The greatest diameter of the anterior tibial artery was characteristic for a trifurcation (IB) and the smallest for subtype IIA 2 (p = 0.04). Both the length (p = 0.03) and luminal diameter (p = 0.04) of the anterior tibial artery in men were significantly greater than in women in all the popliteal subtypes observed. Morphometric parameters of the right and left anterior tibial artery showed no statistically significant differences. The anterior tibial artery was the predominant vessel in a trifurcation (IB) and in the two subtypes with an anterior tibioperoneal trunk (IC, IIB). These results have implications in vascular grafting below the knee.