Arch Hand Microsurg.  2022 Sep;27(3):247-257. 10.12790/ahm.21.0137.

Clinical analysis of the communicating artery between the dorsal and plantar aspects of the foot

• Kwak SH
• Ahn SK
• Kim JH
• Park SH
• Choi HJ

• KMID: 2532742
• DOI: http://doi.org/10.12790/ahm.21.0137

Abstract

Purpose
One of the treatment methods for critical limb ischemia is percutaneous transluminal angioplasty (PTA). In severe cases, however, multiple vessels are blocked, including the main vessels of the lower extremities. This study aimed to determine whether wound healing and symptom relief occurred depending on whether the communicating artery was patent after PTA.
Methods
In total, 120 patients (120 lower extremities) who underwent PTA from January 2016 to February 2018 were followed up for 6 months.
Results
Out of 87 patients who had wounds, 34 had a patent communicating artery and 53 had a non-patent communicating artery. Out of 34 patients who had wounds but a patent communicating artery, 29 completely healed within 6 months. Among the 53 patients who had wounds and a non-patent communicating artery, 16 totally healed within 6 months, and 37 did not heal within 6 months. In the indirect revascularization group, 18 of 21 patients with complete wound healing within 6 months in the indirect revascularization group had a patent communicating artery.
Conclusion
If only indirect revascularization is possible, it is important to ensure the patency of the communicating vessels that link the pedal and plantar arterial systems.

Keyword

Communicating artery; Critical limb ischemia; Revascularization; Wound healing; Percutaneous transluminal angioplasty

Figure

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  Fig. 1. The angiosome concept, which is associated with the vascular territory of the lower extremities.

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  Fig. 2. Diagram of a communicating artery, consisting of a distal communicating artery and a deep plantar artery.

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  Fig. 3. The communicating artery (*) is shown in the foot of a patient with critical limb ischemia (anteroposterior angiographic projection). The dorsalis pedis artery is connected via the communicating artery in the first metatarsal space with the plantar artery.

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  Fig. 4. Preoperative latero-oblique angiographic projection. The plantar artery is not shown in this view.

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  Fig. 5. Postoperative latero-oblique angiographic projection. Retrograde plantar flow is shown through the communicating artery from the dorsalis pedis artery.

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  Fig. 6. After 2 seconds, the plantar arterial flow became clearer due to retrograde flow via the communicating artery.

Reference

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