Yamada T, Gloviczki P, Bower T C, Naessens J M, Carmichael S W
Division of Vascular Surgery, Mayo Clinic and Foundation, Rochester, Minnesota 55905.
Am J Surg. 1993 Aug;166(2):130-5; discussion 135. doi: 10.1016/s0002-9610(05)81043-8.
Reconstruction of the arteries of the foot in patients with severe chronic arterial occlusive disease has become a routine and valuable procedure. However, it is frequently difficult to select the optimal site for the distal arterial anastomosis. In order to determine the most important anatomic variations of foot arteries and the relationship of the dorsalis pedis artery to crossing tendons, the following study was performed in 30 cadaver limbs of 17 persons (9 men and 8 women). Their mean age at death was 69.8 years (range: 42 to 93 years). Methods to evaluate anatomy included anatomic dissection, arteriography, and preparation of corrosion cast models. The latter was performed by injection of liquid plastic and catalyst into the tibial arteries followed by chemical débridement of the soft tissue of the foot. Photographs of the corrosion cast models were taken at various stages of soft tissue dissolution. The dorsalis pedis artery was absent in 6.7% of the cases, and the arcuate artery was absent in 33%. The dorsalis pedis artery arose from the peroneal artery in 6.7%. The dorsalis pedis artery crossed under the extensor hallucis longus tendon at the ankle in 54%, above the ankle in 43%, but below the ankle in only 3%. Our study suggests that the optimal site for the dorsalis pedis artery anastomosis on the foot is the segment distal to the ankle.
对于患有严重慢性动脉闭塞性疾病的患者，足部动脉重建已成为一种常规且有价值的手术。然而，通常很难选择远端动脉吻合的最佳部位。为了确定足部动脉最重要的解剖变异以及足背动脉与交叉肌腱的关系，我们对17人（9名男性和8名女性）的30条尸体下肢进行了以下研究。他们的平均死亡年龄为69.8岁（范围：42至93岁）。评估解剖结构的方法包括解剖、动脉造影和制作腐蚀铸型模型。后者是通过将液体塑料和催化剂注入胫动脉，然后对足部软组织进行化学清创来完成的。在软组织溶解的各个阶段拍摄腐蚀铸型模型的照片。6.7%的病例中足背动脉缺如，33%的病例中弓状动脉缺如。6.7%的病例中足背动脉起自腓动脉。54%的病例中足背动脉在踝关节处从拇长伸肌腱下方穿过，43%在踝关节上方穿过，但仅3%在踝关节下方穿过。我们的研究表明，足部足背动脉吻合的最佳部位是踝关节远端的节段。
