Symptoms of Ischemia Clinical Signs and
Sharad Pendsey in Diabetic Foot, 2004
Although atherosclerosis in patients with diabetes is similar to that seen in nondiabetics, it is generalized, occurs prematurely and progresses at an accelerated pace. Coronary artery, cerebrovascular and peripheral vascular disease (PVD) are the predominant manifestations of macrovascular disease in diabetes. Majority of patients with PVD have associated coronary artery disease, however the opposite is not true. This is perhaps because the clinical manifestations of PVD occur almost a decade later than those of coronary artery disease. In fact the disease of posterior tibial artery commonly seen in diabetics, is a surrogate marker of coronary artery disease.
Distal posterior tibial artery perforator flaps for the management of calcaneal and Achilles tendon injuries in diabetic and non-diabetic patients
Published in Diabetic Foot & Ankle, 2011
Ioannis A. Ignatiadis, Georgios D. Georgakopoulos, Vassiliki A. Tsiampa, Vasilios D. Polyzois, Dimitrios K. Arapoglou, Apostolos E. Papalois
Management of Achilles tendon and heel area defects is a common challenge for the reconstructive surgeon due to the lack of soft tissue availability in that region. In this article, we present our experience in covering these defects by using the distal perforator propeller flaps based on the posterior tibial artery. Perforator flaps are based on cutaneous, small diameter vessels that originate from a main pedicle and perforate the fascia or muscle to reach the skin. Their development has followed the understanding of the blood supply from a source artery to the skin. Six patients (five males and one female) underwent reconstruction by using the posterior tibial artery distal perforator flap for covering defects in the distal Achilles tendon region in patients with and without diabetes mellitus. Postoperative complications included a hypertrophic scar formation in one patient, partial marginal flap necrosis in another patient, and a wound infection in a third patient. All wounds were eventually healed by the last postoperative visit. In conclusion, perforator flaps based on the distal posterior tibial artery may be a reliable option for the coverage of small to moderate size defects of the Achilles tendon and heel area regions.
Mycotic Aneurysm of the Popliteal Artery Secondary to Enterococcus Endocarditis: a Case Report
Published in Acta Chirurgica Belgica, 2014
S. K. Yogeswaran, P. Stabel, J. Avet, G. Daenen
A mycotic popliteal aneurysm (MAAP) is a very rare condition [1]. We describe a 87-year-old Caucasian male who presented with a MAAP of the right leg due to an enterococcus mitral valve endocarditis. The aneurysm was excised and a reversed vein graft was interposed between the normal popliteal artery and the posterior tibial artery. A second vein graft was interposed between the first graft and the anterior tibial artery.
An anatomical study of the blood supply of the soleus muscle in humans
Published in Alexandria Journal of Medicine, 2012
Ehab Mostafa Mohamed El Zawawy, Nancy Mohamed El Sekily
IntroductionThe soleus muscle is a powerful plantar flexor of the ankle joint and receives its blood supply from several different sources. AimThis study was done to describe the distribution of the arterial supply of the soleus muscle. Materials and methodsThe study was carried out at the Faculty of Medicine, University of Alexandria. Forty limbs were dissected, which included specimens from both male and female cadavers. The pattern of arterial supply of the soleus muscle and the distribution of the perforators were studied. ResultsThe soleus muscle is supplied by perforators of the popliteal, posterior tibial and peroneal arteries, the posterior tibial artery gave 38.80% of total perforators while the peroneal artery gave 33.30% of total perforators and the popliteal artery gave 27.80% of total perforators. Perforators of popliteal artery were larger; 12.9 ± 2.07 cm in length and 2.55 ± 0.214 mm in diameter while those of the posterior tibial artery had a length of 5.1 ± 0.99 cm and a diameter of 1.93 ± 0.25 mm and perforators of the peroneal artery had a length of 3.8 ± 0.98 cm and a diameter of 1.49 ± 1.03 mm. ConclusionThe soleus muscle is richly supplied by many arterial pedicles and can be used safely as a free flap, hemisoleus flap or composite flap to cover defects in the lower limb.
Related Knowledge Centers
- Arteries
- Fibular Artery
- Popliteal Artery
- Posterior Tibial Vein
- Lower Limb
- Foot
- Deep Vein