Absence of Clinical and Hemodynamic Consequences due to Posterior Tibial Artery Congenital Aplasia.

Georgios Karaolanis,Viktoria Varvara Palla,Konstantinos Filis,Evridiki Karanikola,George Galyfos

doi:10.1155/2015/821094

Abstract

The exact knowledge of popliteal artery and its branches' anatomic variations is important for the clinical practice of angiology, vascular surgery, and interventional procedures. Congenital absence of the artery leads, in some cases, to early malformations of the extremity in the childhood; however, it may also remain asymptomatic. We present an unusual case of a 76-year-old male patient complaining of paraesthesia in both limbs and bilateral aplasia of posterior tibial artery (PTA). Physical examination, ankle-brachial indexes, before and after exercise, arterial duplex scan, and magnetic resonance arteriography were performed. Arterial pulses for PTA at the level of the ankle were normal; arterial duplex study showed biphasic arterial flow at the level of the ankle. Color duplex ultrasound as well as magnetic resonance arteriography revealed the absence of the PTA in both limbs. The vascularization of the fibula was bilaterally normal. The patient underwent also neurological examination and electromyography, which were normal. The evaluation of the possible clinical signs and symptoms and the hemodynamic consequences of this condition are further discussed.

Highlights

The vascular system is known to exhibit a wide range of anatomical variations
We report an unusual case of a male patient who presented with paraesthesia in both legs, with congenital absence of posterior tibial artery (PTA) bilaterally but without signs or symptoms of peripheral artery disease
Popliteal and peroneal arteries arise from the axial artery whereas the anterior tibial artery (ATA) and PTA arise from the femoral system [5]

Summary

Introduction

The presence of vascular anomalies in patients’ lower extremities has been documented. Recent studies analyzed these variations using angiography as a method of choice and came to the conclusion that variation in popliteal branching was seen in almost 10% of cases. Absence or aplasia of the posterior tibial artery (PTA) has been rarely described [1]. Senior [3] has described the enlargement of PA and the replacement of the PTA in the distal leg and foot through the “peronea magna” and the “great” peroneal artery. We report an unusual case of a male patient who presented with paraesthesia in both legs, with congenital absence of PTA bilaterally but without signs or symptoms of peripheral artery disease

Case Report

Findings

Discussion