Jornal Vascular Brasileiro
Jornal Vascular Brasileiro
Review Article

Avaliação das artérias podais ao eco-Doppler

Assessment of the pedal arteries with Duplex Scanning

Luciana Akemi Takahashi; Graciliano José França; Carlos Eduardo Del Valle; Luis Ricardo Coelho Ferreira

Downloads: 0
Views: 1363


Resumo: A ultrassonografia vascular com Doppler é um método não invasivo útil no diagnóstico e planejamento terapêutico da doença oclusiva das artérias podais. A artéria pediosa dorsal é a continuação direta da artéria tibial anterior e tem trajeto retilíneo no dorso do pé, dirigindo-se medialmente ao primeiro espaço intermetatarsiano, onde dá origem a seus ramos terminais. A artéria tibial posterior distalmente ao maléolo medial se bifurca e dá origem às artérias plantar lateral e plantar medial. A plantar medial apresenta menor calibre e segue medialmente na planta do pé, enquanto a plantar lateral é mais calibrosa, seguindo um curso lateral na região plantar e formando o arco plantar profundo, o qual se anastomosa com a artéria pediosa dorsal através da artéria plantar profunda. A avaliação das artérias podais pode ser realizada de maneira não invasiva com exame de eco-Doppler, com adequado nível de detalhamento anatômico.


ultrassonografia Doppler, artérias da tíbia, procedimentos cirúrgicos vasculares


Vascular Doppler ultrasound is a noninvasive method that can help in diagnostic and therapeutic planning in case of pedal arterial obstructive disease. The dorsalis pedis artery is the direct continuation of the anterior tibial artery and follows a straight course along the dorsum of the foot, leading medially to the first intermetatarsal space, where it gives off its terminal branches. The posterior tibial artery forks distal to the medial malleolus and gives rise to the lateral plantar and medial plantar arteries. The medial plantar artery has a smaller caliber and runs medially in the sole of the foot, while the lateral plantar artery is of larger caliber, following a lateral course in the plantar region and forming the deep plantar arch, which anastomoses with the dorsalis pedis artery via the deep plantar artery. The arteries of the foot can be assessed noninvasively with Doppler, providing an adequate level of anatomical detail.


Doppler ultrasonography, duplex; tibial arteries; vascular surgery procedures.


1 Conte MS, Bradbury AW, Kolh P, et al. Global vascular guidelines on the management of chronic limb-threatening ischemia. J Vasc Endovasc Surg. 2019;69(6S):3S-125S.e40.

2 Manzi M, Cester G, Palena LM, Alek J, Candeo A, Ferraresi R. Vascular imaging of the foot: the first step toward endovascular recanalization. Radiographics. 2011;31(6):1623-36. PMid:21997985.

3 Higashimori A, Iida O, Yamauchi Y, et al. Outcomes of one straight-line flow with and without pedal arch in patients with critical limb ischemia. Catheter Cardiovasc Interv. 2016;87(1):129-33. PMid:26489531.

4 Rashid H, Slim H, Zayed H, et al. The impact of arterial pedal arch quality and angiosome revascularization on foot tissue loss healing and infrapopliteal bypass outcome. J Vasc Surg. 2013;57(5):1219-26. PMid:23523278.

5 Meyer A, Schinz K, Lang W, Schmid A, Regus S, Rother U. Outcomes and influence of the pedal arch in below-the-knee angioplasty in patients with end-stage renal disease and critical limb ischemia. Ann Vasc Surg. 2016;35:121-9. PMid:27238998.

6 Sommerset J, Teso D, Feliciano B, et al. Innovative arterial duplex examination: a guide to evaluate flow in the foot using pedal acceleration time. J Vasc Ultrasound. 2019;43(1):11-7.

7 Hofmann WJ, Magometschnigg H. Pedal artery bypass. Acta Chir Belg. 2004;104(6):654-8. PMid:15663270.

8 Hingorani AP, Ascher E, Marks N, et al. Limitations of and lessons learned from clinical experience of 1,020 duplex arteriography. Vascular. 2008;16(3):147-53. PMid:18674463.

9 Manzi M, Palena LM. Treating calf and pedal vessel disease: the extremes of intervention. Semin Intervent Radiol. 2014;31(4):313-9. PMid:25435656.

10 Mustapha JA, Diaz-Sandoval LJ, Saab F. Tibial-pedal arterial access & retrograde interventions for advanced peripheral arterial disease & critical limb ischemia. Interv Cardiol (Lond). 2015;7(5):451-67.

11 Gray H. The arteries of the lower extremity. In: Anatomy of the human body.; 1918. [atualizado 2000; citado 2019 nov 11].

12 Roedersheimer LR, Feins R, Green RM. Doppler evaluation of the pedal arch. Am J Surg. 1981;142(5):601-4. PMid:7304817.

13 Haine A, Haynes AG, Limacher A, et al. Patency of the arterial pedal-plantar arch in patients with chronic kidney disease or diabetes mellitus. Ther Adv Cardiovasc Dis. 2018;12(5):145-53. PMid:29431578.

14 Alson MD, Lang EV, Kaufman JA. Pedal arterial imaging. J Vasc Interv Radiol. 1997;8(1 Pt 1):9-18. PMid:9025033.

15 Eiberg JP, Hansen MA, Jørgensen LG, Rasmussen JB, Jensen F, Schroeder TV. In-situ bypass surgery on arteriographically invisible vessels detected by Doppler-ultrasound for limb salvage. J Cardiovasc Surg (Torino). 2004;45(4):375-9. PMid:15365518.

16 Hofmann WJ, Walter J, Ugurluoglu A, Czerny M, Forstner R, Magometschnigg HH. Preoperative high-frequency duplex scanning of potential pedal target vessels. J Vasc Surg. 2004;39(1):169-75. PMid:14718835.

Submitted date:

Accepted date:

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5fcf78020e8825ee524ac228 jvb Articles

J Vasc Bras

Share this page
Page Sections