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Applied Surgical Anatomy
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Vishal G Shelat, Andrew Clayton Lee, Julian Wong, Karen Randhawa, CJ Shukla, Choon Sheong Seow, Tjun Tang
What is the blood supply of the foot?Anterior tibial artery crosses the ankle anteriorly beneath the extensor retinaculum to become the dorsalis pedis artery found just lateral to extensor hallucis longus tendon. It forms the dorsal arch artery. It supplies mainly the dorsum of the foot and generally the medial three toes.The posterior tibial artery provides blood supply to the plantar surface of the foot and the lateral aspect of the foot and heel. It runs posterior to the medial malleolus between the tendon of flexor hallucis longus and the posterior tibial nerve. It passes deep to the flexor retinaculum to divide into medial and lateral plantar arteries and forms the plantar arch with the dorsalis pedis artery.The peroneal artery divides into anterior and posterior division branches and supplies generally down to the ankle, and in some aberrant anatomies, feeds both the posterior and anterior tibial arteries.
Peripheral Vessel Doppler
Published in Swati Goyal, Essentials of Abdomino-Pelvic Sonography, 2018
Popliteal artery branches: Anterior tibial artery becomes dorsalis pedis artery of foot.Posterior tibial artery.Peroneal artery.
OCT assessment out of the coronary arteries
Published in Hiram G. Bezerra, Guilherme F. Attizzani, Marco A. Costa, OCT Made Easy, 2017
Jun Li, Daniel Kendrick, Vikram S. Kashyap, Sahil A. Parikh
A 65-year-old woman with previous femoral–tibial venous bypass presents with recurrent claudication and is found to have a high-grade stenosis after the distal anastomosis on ultrasound. Angiography demonstrates a subtotally occlusive lesion consistent with NIH of the posterior tibial artery, beyond the distal anastomosis. OCT confirms the presence of a severe fibrotic stenosis in the native artery (Figure 9.2e); the anastomosis and vein graft are widely patent (Figure 9.2f).
Preliminary outcomes of combined surgical approach for lower extremity lymphedema: supraclavicular lymph node transfer and lymphaticovenular anastomosis
Published in Journal of Plastic Surgery and Hand Surgery, 2022
Jae-Ho Chung, Yong-Jae Hwang, Seung-Ha Park, Eul-Sik Yoon
There are also many different opinions with regard to the recipient site for VLNT [13,24,25]. In general, the groin and popliteal fossa are considered a poor candidates for the recipient site, because it is theoretically unreasonable that the transferred lymph nodes absorb the lymph fluid against the force of gravity. Published literatures to date have suggested the dorsal crease of ankle as a main recipient site [3,5,27]. However, in this study, we used the posterior tibial artery as a recipient vessel due to several advantages. The posterior tibial artery is a traditionally used recipient site for the reconstruction of the lower extremity. It can preserve the distal circulation of the lower extremity when an anastomosis is performed in an end-to-side fashion. Also, it is advantageous to secure space for flap insetting, and leaves a less prominent scar than an anterior recipient site.
Aortic thrombosis in a neonate with COVID-19-related fetal inflammatory response syndrome requiring amputation of the leg: a case report
Published in Paediatrics and International Child Health, 2021
Priyanka S. Amonkar, Jeetendra B. Gavhane, Suhas N. Kharche, Sameer S. Kadam, Dattatray B. Bhusare
Haemoglobin was 15.3 g/dl, total white cell count 17.1×109/L (21% lymphocytes, 67% neutrophils, neutrophil lymphocyte ratio 3.1) and platelet count was 204×109/L (Table 1). Chest radiograph was normal. C-reactive protein (CRP) was 186 mg/L (<3) and other results on Day 1 of hospitalisation (Day 10 of life) are shown in Table 1. After drawing blood for culture, intravenous antibiotics were commenced. Doppler revealed acute thrombosis of the abdominal aorta below the level of the renal arteries (80–90% occlusion) with a critically ischaemic right lower limb (Figure 2). No blood flow was seen from the right common iliac artery onwards. The left common iliac, femoral and popliteal arteries showed a feeble flow. Unfractioned heparin infusion was commenced (bolus at 80 U/kg, maintenance 28 U/kg/hr). The dose was adjusted by monitoring activated partial thromboplastin time. In view of no improvement, he was thrombolysed with recombinant tissue plasminogen activator (r-TPA) (bolus 0.1 mg/kg, maintenance 0.9 mg/kg). Post-thrombolysis, heparin infusion was continued. Doppler showed slightly improved circulation in both lower limbs with blood flow in the right posterior tibial artery and right anterior tibial artery distally up to 2 cm above the ankle joint.
Feasibility and estimated efficacy of blood flow restricted training in female patients with rheumatoid arthritis: a randomized controlled pilot study
Published in Scandinavian Journal of Rheumatology, 2021
AB Jønsson, CV Johansen, N Rolving, M Pfeiffer-Jensen
At the patient’s first enquiry regarding the study, written and verbal information about the project was given. For patients accepting participation, informed consent was obtained. Before the clinical tests at baseline, which were performed by two physiotherapists, anthropometric and demographic data were collected using a questionnaire together with the 28-joint Disease Activity Score (DAS28) (Table 1). The DAS28 was used to describe the study population in terms of disease-specific measures and to ensure that patients’ disease activity was the same at baseline and follow-up. To determine the training occlusion pressure for the intervention group, ultrasound with Doppler effect and a 7 cm wide occlusion cuff with a pressure gauge was used. As total limb arterial occlusion pressure (AOP) is influenced by the body position (16), the patient was placed in a seated position to imitate the positions of the exercises. The cuff was positioned near the inguinal fold region (Figure 1). After 5 min of rest, the posterior tibial artery pulse was detected using a Doppler probe (Figure 1). AOP was identified by inflating the cuff and increasing the pressure until the auscultatory pulse was no longer present. This methodical approach was used on both legs with 5 min of rest between the measurements. The training occlusion pressure was achieved by setting the tourniquet to 50% of AOP. After the clinical tests, the participants were randomized using sealed opaque envelopes.