Similarities and dissimilarities of the blood supplies of the human sciatic, tibial, and common peroneal nerves

Abstract

The aim was to investigate the arterial supply of the sciatic, tibial, and common peroneal nerves. Thirty-six lower limbs of 18 human fetuses were studied. The fetuses had been fixed in buffered formalin and the blood vessels injected with barium sulfate. Fetal age ranged from 12 to 28 weeks of gestation. Microdissection of the fetal lower extremities was done under ×5 magnifying lenses. The sciatic nerves of 10 lower extremities were dissected and excised and radiographs taken. The extraneural arterial chain of the sciatic nerve was composed of 2-6 arterial branches of the inferior gluteal artery, the medial circumflex femoral artery, the perforating arteries, and the popliteal artery. The extraneural arterial chain of tibial nerve was composed of 2-5 arteries, which were branches of the popliteal, the peroneal, and the posterior tibial arteries. Radiographs showed the presence of complete intraneural arterial chains in the sciatic and tibial nerves, formed from anastomosing vessels. Dissection showed that, in 97.2% of the specimens, the common peroneal nerve was supplied only by one popliteal artery branch, the presence of which was confirmed radiologically. The sciatic and tibial nerves are supplied by numerous arterial branches of different origins, which provide for collateral circulation. In contrast, the common peroneal nerve is most frequently supplied only by one elongated longitudinal blood vessel, a branch of the popliteal artery. Such a vascular arrangement may make the common peroneal nerve less resistant to stretching and compression.

Accompanying artery of sciatic nerve as recipient vessel for free‐flap transfer: A computed tomographic angiography study and case reports

“…Anatomists have traditionally considered it to be the persistent sciatic artery 7 ; however, recent studies suggest that most of the accompanying arteries that had been reported were not truly primitive sciatic arteries and should be regarded as representing a secondary anastomosis between the inferior gluteal and popliteal arteries . In fact, the accompanying artery of the sciatic nerve is not a single axial artery but comprises a continuous anastomotic chain of arteries, including the inferior gluteal artery, medial circumflex femoral artery, perforating arteries of the deep femoral artery, and popliteal artery . The findings of our CT angiography study are largely consistent with those of previous reports.…”

“…If the accompanying artery of the sciatic nerve is used as a recipient vessel for free‐flap transfer, ischemia of the sciatic nerve is a concern. As mentioned earlier, the sciatic nerve is not supplied by a single elongated longitudinal artery but is supplied segmentally by numerous arterial branches of different origins . Therefore, we believe that the risk of ischemia of the sciatic nerve would not be present even if the accompanying artery were transected in a single place.…”

Magnetic resonance neurography detects diabetic neuropathy early and with Proximal Predominance

“…Why nerve segments at the thigh level should be susceptible to microstructural alteration induced by ischemic and/or metabolic mechanisms is unknown. It can be speculated that these nerve segments experience inferior protection by nutritive microvascular supply because they are located at a hemodynamic watershed region of nerve perfusion 33, 34, 35. Altogether, the accumulation of microstructural nerve alterations at the thigh level, which may represent a vulnerable region for ischemic and/or metabolic injury, may precede and possibly trigger distal fiber loss in a length‐dependent manner in which the distal fibers tend to die first.…”

The Tibial Nerve and Its Vasculature: An Anatomical Evaluation

“…The pattern of vascularization is present in the major trunk of the tibial and sciatic nerves. Two to six arteries are needed to form the extraneural arterial chain of the sciatic nerve, which pass to it from neighboring arteries, perforating, popliteal artery, inferior gluteal, and medial circumflex femoral at the certain level (Ugrenovic et al, 2013).…”