Redefining Vascular Anatomy of Posterior Tibial Artery Perforators

Abstract

Clinically optimal perforators for the first time were precisely located in relation to subfascial directionality, vascular diameter, and length from the source artery. Continuous improving details of vascular anatomy will further evolve perforator flaps' applications.

Delineation the anatomy of posterior tibial artery perforator flaps using human cadavers with a modified technique

“…However, controversial evidence has been recorded by other studies about the distribution of posterior tibial artery perforators. Drimouras et al [6] observed that most of the perforators were concentrated in the middle and distal tertile, predominatly septocutaneous perforators followed by musculocutaneous and septomusculocutaneous. Our findings provided noticeable insight into the anatomy of perforator flaps and helped reconstructive surgeons in handling perforator flaps.…”

Three-Dimensional Computed Tomographic Angiography Study of the Interperforator Flow of the Lower Leg

“…[7][8][9][10][11][12][13][14][15] However, even if we could locate an appropriate perforator accurately, it is not possible to make an exact estimate of the maximum area or width-to-length ratio of a specific perforator.…”

Reconstruction of Medial Malleolar Defect Using Posterior Tibial Artery Perforator Based Deep Fascial Flap after Malignant Melanoma Ablation

“…The posterior tibial artery has many segmental perforators in the posteromedial aspect of the lower leg. According to Drimouras et al [4], five perforators are produced on average, which tend to gather in the lower two-thirds. The direction of the perforators varies widely and mostly emerges as a septum between the soleus muscle and the flexor digitorum longus.…”

“…The posterior tibial artery is a vessel that supplies all the superficial compartments, except the medial head of the gastrocnemius muscle, and delivers a perforator that feeds this compartment through the deep fascia [6]. This segmental perforator produces a good anastomotic arcade, supplying the deep fascia [4].…”