Vol 64, No 1 (2005)
Original article
Submitted: 2012-02-06
Published online: 2004-12-10
Compensating crural anastomoses in chronic critical limb ischaemia
M. Szpinda
Folia Morphol 2005;64(1):17-21.
Vol 64, No 1 (2005)
ORIGINAL ARTICLES
Submitted: 2012-02-06
Published online: 2004-12-10
Abstract
Compensating crural anastomoses develop in patients with multi-level occlusion of
the calf arteries in the course of atherosclerosis, arteriitis, diabetes, and in vascular
malformations of the limbs. The peroneal artery is frequently the only patent calf
vessel, especially in diabetic patients who have advanced tibial occlusive disease.
The purpose of this study was to identify different types of compensating crural
anastomoses in chronic critical limb ischaemia. Using combined anatomical-radiographic
and statistical methods, 86 compensating crural anastomoses were studied
in 59 specimens of lower limbs (amputated at the thigh) in the course of chronic
critical ischaemia. Three types of compensating crural anastomosis and their
components were identified. The most common type (55.8%) was the posterior
tibioperoneal anastomosis. Less common (23.3%) was the intertibial anastomosis
and least common (20.9%) the anterior tibioperoneal anastomosis. The posterior
tibioperoneal anastomosis was concurrent with anterior tibioperoneal anastomosis
in 26.3% of cases and with the intertibial anastomosis in 15.3% of cases. The great
importance of the peroneal artery in the formation of natural crural collateral circulation
should encourage vascular surgeons to consider peroneal bypasses.
Abstract
Compensating crural anastomoses develop in patients with multi-level occlusion of
the calf arteries in the course of atherosclerosis, arteriitis, diabetes, and in vascular
malformations of the limbs. The peroneal artery is frequently the only patent calf
vessel, especially in diabetic patients who have advanced tibial occlusive disease.
The purpose of this study was to identify different types of compensating crural
anastomoses in chronic critical limb ischaemia. Using combined anatomical-radiographic
and statistical methods, 86 compensating crural anastomoses were studied
in 59 specimens of lower limbs (amputated at the thigh) in the course of chronic
critical ischaemia. Three types of compensating crural anastomosis and their
components were identified. The most common type (55.8%) was the posterior
tibioperoneal anastomosis. Less common (23.3%) was the intertibial anastomosis
and least common (20.9%) the anterior tibioperoneal anastomosis. The posterior
tibioperoneal anastomosis was concurrent with anterior tibioperoneal anastomosis
in 26.3% of cases and with the intertibial anastomosis in 15.3% of cases. The great
importance of the peroneal artery in the formation of natural crural collateral circulation
should encourage vascular surgeons to consider peroneal bypasses.
Keywords
collateral circulation; by-pass; occlusive disease
Title
Compensating crural anastomoses in chronic critical limb ischaemia
Journal
Folia Morphologica
Issue
Vol 64, No 1 (2005)
Article type
Original article
Pages
17-21
Published online
2004-12-10
Page views
450
Article views/downloads
1491
Bibliographic record
Folia Morphol 2005;64(1):17-21.
Keywords
collateral circulation
by-pass
occlusive disease
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