Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.202400301
Jornal Vascular Brasileiro
Case Report

Diagnóstico e implicações clínicas de variação anômala da artéria tibial anterior por ultrassom vascular: relato de caso

Vascular ultrasound diagnosis and clinical implications of aberrant anterior tibial artery: case report

Mariana Jordão França; Luciana Akemi Takahashi; Graciliano José França

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Resumo

O membro inferior é vascularizado pela artéria femoral, a qual se continua em artéria poplítea. Após a borda distal do músculo poplíteo, a artéria poplítea se divide em artéria tibial anterior e posterior. Variações anatômicas na bifurcação da artéria poplítea ocorrem com frequência, e uma dessas variações é a artéria tibial anterior aberrante, na qual a artéria apresenta trajeto anterior ao músculo poplíteo em vez de ter percurso dorsal. Reportamos um diagnóstico dessa variação anatômica em um paciente com queixa de claudicação intermitente no membro inferior esquerdo. O exame de ultrassom vascular excluiu a possibilidade de qualquer lesão arterial obstrutiva e constatou uma bifurcação alta da artéria poplítea, além de identificar o percurso da artéria tibial anterior aberrante, posicionada anteriormente ao músculo poplíteo e ao córtex tibial posterior. Essa variação anômala apresenta grande importância clínica, especialmente em procedimentos cirúrgicos no joelho. Lesões cirúrgicas dessa artéria podem levar à formação de pseudoaneurisma, síndrome compartimental, necrose ou até mesmo amputação do membro.

Palavras-chave

ultrassom Doppler; artéria tibial anterior; variação anatômica; relato de caso

Abstract

The lower limb is vascularized by the femoral artery, which continues as the popliteal artery. After the distal margin of the popliteus muscle, the popliteal artery divides into the anterior and posterior tibial arteries. Anatomical variations in the bifurcation of the popliteal artery are frequent. One such variation is the aberrant anterior tibial artery, in which the artery runs anterior to the popliteus muscle instead of following the normal dorsal course. We report a case in which this anatomical variation was diagnosed with vascular ultrasound in a patient complaining of intermittent claudication in the left lower limb. The examination ruled out any possibility of obstructive arterial injury and identified a high bifurcation of the popliteal artery and the anterior tibial artery running anterior to the popliteus muscle and the tibial cortex. This anomalous variation is of great clinical importance, especially in surgical procedures involving the knee. Surgical injury to these arteries can lead to formation of pseudoaneurysm, compartment syndrome, or necrosis and can even result in limb amputation.

Keywords

Doppler ultrasound; anterior tibial artery; anatomical variation; case report

References

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Submitted date:
03/13/2024

Accepted date:
07/25/2024

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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