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Published in: BMC Musculoskeletal Disorders 1/2021

Open Access 01-12-2021 | Magnetic Resonance Imaging | Research article

Prevalence and characteristics of the aberrant anterior tibial artery: a single-center magnetic resonance imaging study and scoping review

Authors: Julio Marin-Concha, Pablo Rengifo, Pedro Tapia, Daniel Kaiser, Timo Siepmann

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

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Abstract

Background

Planning surgical procedures of the lower leg benefits from considering the possibility of an aberrant anterior tibial artery (AATA), but previously published data on the frequency of this anatomic variant shows heterogeneity. We assessed the prevalence of AATA in a Latin American cohort using magnetic resonance imaging (MRI) and compared these with other studies reported in the literature.

Methods

We retrospectively included consecutive patients who had undergone multiplanar knee MRI at a radiology department in Lima, Peru. The MRI protocol included coronal T1 weighted, axial, sagittal and coronal proton density fat-saturated (PDFS) and sagittal T2 weighted images.
Two experienced radiologists assessed all images and were blinded to each other’s findings. The frequency of the AATA was compared to previous cohorts. A scoping review was undertaken to provide an overview of previously published data on the prevalence of ATAA.

Results

We analyzed 280 knee MRI examinations of 253 patients (median age 41 years (IQR 31–52), 53.8% male). The aberrant anterior tibial artery variant was present in 8 of 280 (2.9%) evaluated knees, resulting in a prevalence of 3.2% in our study population. The PDFS sequence in the axial or sagittal orientation was most effective to identify AATA. The frequency of AATA in the reviewed literature using different radiological modalities ranged from 0.4 to 6% (median 1%, IQR (0.5–2.3%).

Conclusions

The AATA is a frequent vascular variant that can be detected by MRI in the preparation of invasive interventions of the lower leg.
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Literature
1.
go back to reference Kropman RH, Kiela G, Moll FL, de Vries JP. Variations in anatomy of the popliteal artery and its side branches. Vasc Endovasc Surg. 2011;45(6):536–40.CrossRef Kropman RH, Kiela G, Moll FL, de Vries JP. Variations in anatomy of the popliteal artery and its side branches. Vasc Endovasc Surg. 2011;45(6):536–40.CrossRef
2.
go back to reference Colborn GL, Lumsden AB, Taylor BS, Skandalakis JE. The surgical anatomy of the popliteal artery. Am Surg. 1994;60(4):238–46.PubMed Colborn GL, Lumsden AB, Taylor BS, Skandalakis JE. The surgical anatomy of the popliteal artery. Am Surg. 1994;60(4):238–46.PubMed
3.
go back to reference Langkamer VG. Local vascular complications after knee replacement: a review with illustrative case reports. Knee. 2001;8(4):259–64.CrossRef Langkamer VG. Local vascular complications after knee replacement: a review with illustrative case reports. Knee. 2001;8(4):259–64.CrossRef
4.
go back to reference Daniels SP, Sneag DB, Berkowitz JL, Trost D, Endo Y. Pseudoaneurysm after total knee arthroplasty: imaging findings in 7 patients. Skelet Radiol. 2019;48(5):699–706.CrossRef Daniels SP, Sneag DB, Berkowitz JL, Trost D, Endo Y. Pseudoaneurysm after total knee arthroplasty: imaging findings in 7 patients. Skelet Radiol. 2019;48(5):699–706.CrossRef
5.
go back to reference Gaetke-Udager K, Fessell DP, Liu PS, Morag Y, Brigido MK, Yablon C, et al. Knee MRI: vascular pathology. AJR Am J Roentgenol. 2015;205(1):142–9.CrossRef Gaetke-Udager K, Fessell DP, Liu PS, Morag Y, Brigido MK, Yablon C, et al. Knee MRI: vascular pathology. AJR Am J Roentgenol. 2015;205(1):142–9.CrossRef
6.
go back to reference Kim D, Orron DE, Skillman JJ. Surgical significance of popliteal arterial variants. A unified angiographic classification. Ann Surg. 1989;210(6):776–81.CrossRef Kim D, Orron DE, Skillman JJ. Surgical significance of popliteal arterial variants. A unified angiographic classification. Ann Surg. 1989;210(6):776–81.CrossRef
7.
go back to reference Trotter M. The level of termination of the popliteal artery in the white and the negro. Am J Phys Anthropol. 1940;27(1):109–18.CrossRef Trotter M. The level of termination of the popliteal artery in the white and the negro. Am J Phys Anthropol. 1940;27(1):109–18.CrossRef
8.
go back to reference Yanik B, Bulbul E, Demirpolat G. Variations of the popliteal artery branching with multidetector CT angiography. Surg Radiol Anat. 2015;37(3):223–30.CrossRef Yanik B, Bulbul E, Demirpolat G. Variations of the popliteal artery branching with multidetector CT angiography. Surg Radiol Anat. 2015;37(3):223–30.CrossRef
9.
go back to reference Klecker RJ, Winalski CS, Aliabadi P, Minas T. The aberrant anterior tibial artery: magnetic resonance appearance, prevalence, and surgical implications. Am J Sports Med. 2008;36(4):720–7.CrossRef Klecker RJ, Winalski CS, Aliabadi P, Minas T. The aberrant anterior tibial artery: magnetic resonance appearance, prevalence, and surgical implications. Am J Sports Med. 2008;36(4):720–7.CrossRef
10.
go back to reference Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467–73.CrossRef Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467–73.CrossRef
12.
go back to reference Prayer L, Karnel F, Schurawitzki H. Angiographic imaging of the branching of the popliteal artery into the arteries of the lower leg. Röntgenpraxis. 1990;43(3):100–3.PubMed Prayer L, Karnel F, Schurawitzki H. Angiographic imaging of the branching of the popliteal artery into the arteries of the lower leg. Röntgenpraxis. 1990;43(3):100–3.PubMed
13.
go back to reference Voboril R. Note on variability of the arteries of the lower extremities in man. Folia Morphol (Praha). 1990;38(3):265–72. Voboril R. Note on variability of the arteries of the lower extremities in man. Folia Morphol (Praha). 1990;38(3):265–72.
14.
go back to reference Szpinda M. An angiographic study of the anterior tibial artery in patients with aortoiliac occlusive disease. Folia Morphol (Warsz). 2006;65(2):126–31. Szpinda M. An angiographic study of the anterior tibial artery in patients with aortoiliac occlusive disease. Folia Morphol (Warsz). 2006;65(2):126–31.
15.
go back to reference Mavili E, Dönmez H, Kahriman G, Özaşlamacı A, Özcan N, Taşdemir K. Popliteal artery branching patterns detected by digital subtraction angiography. Diagn Interv Radiol (Ankara, Turkey). 2011;17(1):80–3. Mavili E, Dönmez H, Kahriman G, Özaşlamacı A, Özcan N, Taşdemir K. Popliteal artery branching patterns detected by digital subtraction angiography. Diagn Interv Radiol (Ankara, Turkey). 2011;17(1):80–3.
16.
go back to reference Celtikci P, Ergun O, Durmaz HA, Conkbayir I, Hekimoglu B. Evaluation of popliteal artery branching patterns and a new subclassification of the ‘usual’ branching pattern. Surg Radiol Anat. 2017;39(9):1005–15.CrossRef Celtikci P, Ergun O, Durmaz HA, Conkbayir I, Hekimoglu B. Evaluation of popliteal artery branching patterns and a new subclassification of the ‘usual’ branching pattern. Surg Radiol Anat. 2017;39(9):1005–15.CrossRef
17.
go back to reference Keen JA. A study of the arterial variations in the limbs, with special reference to symmetry of vascular patterns. Am J Anat. 1961;108:245–61.CrossRef Keen JA. A study of the arterial variations in the limbs, with special reference to symmetry of vascular patterns. Am J Anat. 1961;108:245–61.CrossRef
18.
go back to reference Kil SW, Jung GS. Anatomical variations of the popliteal artery and its tibial branches: analysis in 1242 extremities. Cardiovasc Intervent Radiol. 2009;32(2):233–40.CrossRef Kil SW, Jung GS. Anatomical variations of the popliteal artery and its tibial branches: analysis in 1242 extremities. Cardiovasc Intervent Radiol. 2009;32(2):233–40.CrossRef
19.
go back to reference Calisir C, Simsek S, Tepe M. Variations in the popliteal artery branching in 342 patients studied with peripheral CT angiography using 64-MDCT. Jpn J Radiol. 2015;33(1):13–20.CrossRef Calisir C, Simsek S, Tepe M. Variations in the popliteal artery branching in 342 patients studied with peripheral CT angiography using 64-MDCT. Jpn J Radiol. 2015;33(1):13–20.CrossRef
20.
go back to reference Tindall AJ, Shetty AA, James KD, Middleton A, Fernando KW. Prevalence and surgical significance of a high-origin anterior tibial artery. J Orthop Surg (Hong Kong). 2006;14(1):13–6.CrossRef Tindall AJ, Shetty AA, James KD, Middleton A, Fernando KW. Prevalence and surgical significance of a high-origin anterior tibial artery. J Orthop Surg (Hong Kong). 2006;14(1):13–6.CrossRef
21.
go back to reference Bolog NV, Andreisek G, Ulbrich EJ. MRI of the knee: a guide to evaluation and reporting. Switzerland: Springer International Publishing; 2015. p. 189–204. Bolog NV, Andreisek G, Ulbrich EJ. MRI of the knee: a guide to evaluation and reporting. Switzerland: Springer International Publishing; 2015. p. 189–204.
22.
go back to reference Oztekin PS, Ergun E, Cıvgın E, Yigit H, Kosar PN. Variants of the popliteal artery terminal branches as detected by multidetector ct angiography. Open Med (Warsaw, Poland). 2015;10(1):483–91. Oztekin PS, Ergun E, Cıvgın E, Yigit H, Kosar PN. Variants of the popliteal artery terminal branches as detected by multidetector ct angiography. Open Med (Warsaw, Poland). 2015;10(1):483–91.
23.
go back to reference Levinsohn EM, Hootnick DR, Packard DS Jr. Consistent arterial abnormalities associated with a variety of congenital malformations of the human lower limb. Investig Radiol. 1991;26(4):364–73.CrossRef Levinsohn EM, Hootnick DR, Packard DS Jr. Consistent arterial abnormalities associated with a variety of congenital malformations of the human lower limb. Investig Radiol. 1991;26(4):364–73.CrossRef
24.
go back to reference Rohan A, Domagała Z, Abu Faraj S, Korykowska A, Klekowski J, Pospiech N, et al. Branching patterns of the foetal popliteal artery. Folia Morphol (Warsz). 2019;78(1):71–8. Rohan A, Domagała Z, Abu Faraj S, Korykowska A, Klekowski J, Pospiech N, et al. Branching patterns of the foetal popliteal artery. Folia Morphol (Warsz). 2019;78(1):71–8.
25.
go back to reference Demirtaş H, Değirmenci B, Çelik AO, Umul A, Kara M, Aktaş AR, et al. Anatomic variations of popliteal artery: evaluation with 128-section CT-angiography in 1261 lower limbs. Diagn Interv Imaging. 2016;97(6):635–42.CrossRef Demirtaş H, Değirmenci B, Çelik AO, Umul A, Kara M, Aktaş AR, et al. Anatomic variations of popliteal artery: evaluation with 128-section CT-angiography in 1261 lower limbs. Diagn Interv Imaging. 2016;97(6):635–42.CrossRef
26.
go back to reference Oner S, Oner Z. Popliteal artery branching variations: a study on multidetector CT angiography. Sci Rep. 2020;10(1):8147.CrossRef Oner S, Oner Z. Popliteal artery branching variations: a study on multidetector CT angiography. Sci Rep. 2020;10(1):8147.CrossRef
27.
go back to reference Senior HD. Abnormal branching of the human popliteal artery. Am J Anat. 1929;44(1):111–20.CrossRef Senior HD. Abnormal branching of the human popliteal artery. Am J Anat. 1929;44(1):111–20.CrossRef
28.
go back to reference Olewnik Ł, Łabętowicz P, Podgórski M, Polguj M, Ruzik K, Topol M. Variations in terminal branches of the popliteal artery: cadaveric study. Surg Radiol Anat. 2019;41(12):1473–82.CrossRef Olewnik Ł, Łabętowicz P, Podgórski M, Polguj M, Ruzik K, Topol M. Variations in terminal branches of the popliteal artery: cadaveric study. Surg Radiol Anat. 2019;41(12):1473–82.CrossRef
29.
go back to reference Day CP, Orme R. Popliteal artery branching patterns -- an angiographic study. Clin Radiol. 2006;61(8):696–9.CrossRef Day CP, Orme R. Popliteal artery branching patterns -- an angiographic study. Clin Radiol. 2006;61(8):696–9.CrossRef
30.
go back to reference Lippert H, Pabst R. Arterial variations in man: classification and frequency: Springer; 1985. Lippert H, Pabst R. Arterial variations in man: classification and frequency: Springer; 1985.
31.
go back to reference Adachi B. Das arterinsystem der Japaner. Band 1. A maxillaris interna; 1928. p. 85–96. Adachi B. Das arterinsystem der Japaner. Band 1. A maxillaris interna; 1928. p. 85–96.
32.
go back to reference Davies B, Husami T, Lewis J, Retrum E. Developmental variations of the popliteal artery and its branches: a clinical correlation. Contemp Surg. 1989;34:28–32. Davies B, Husami T, Lewis J, Retrum E. Developmental variations of the popliteal artery and its branches: a clinical correlation. Contemp Surg. 1989;34:28–32.
33.
go back to reference Soler AG-C, Quiles-Guiñau L, Mata-Escolano F, Sanchis-Gimeno JA. Anatomic variations of the popliteal artery branches in present Spaniard population. Ital J Anat Embryol. 2017;122(3):206–15. Soler AG-C, Quiles-Guiñau L, Mata-Escolano F, Sanchis-Gimeno JA. Anatomic variations of the popliteal artery branches in present Spaniard population. Ital J Anat Embryol. 2017;122(3):206–15.
34.
go back to reference Yildiz S, Yazar F, Ozan H. A high-origin anterior tibial artery and its current clinical importance. Int J Anat Var. 2010;3:180–2. Yildiz S, Yazar F, Ozan H. A high-origin anterior tibial artery and its current clinical importance. Int J Anat Var. 2010;3:180–2.
36.
go back to reference Padegimas EM, Levicoff EA, McGinley AD, Sharkey PF, Good RP. Vascular complications after total knee arthroplasty-a single institutional experience. J Arthroplast. 2016;31(7):1583–8.CrossRef Padegimas EM, Levicoff EA, McGinley AD, Sharkey PF, Good RP. Vascular complications after total knee arthroplasty-a single institutional experience. J Arthroplast. 2016;31(7):1583–8.CrossRef
37.
go back to reference Zhao R, Li Y, Liu Y, Zhang K, Liu Z. Pseudoaneurysm of a high-division anterior tibial artery following primary TKA. Orthopade. 2017;46(3):275–9.CrossRef Zhao R, Li Y, Liu Y, Zhang K, Liu Z. Pseudoaneurysm of a high-division anterior tibial artery following primary TKA. Orthopade. 2017;46(3):275–9.CrossRef
38.
go back to reference Chamseddin KH, Kirkwood ML. Anterior tibial artery pseudoaneurysm following ankle arthroscopy in a hemophiliac patient. Ann Vasc Surg. 2016;34:269.e17–.e19.CrossRef Chamseddin KH, Kirkwood ML. Anterior tibial artery pseudoaneurysm following ankle arthroscopy in a hemophiliac patient. Ann Vasc Surg. 2016;34:269.e17–.e19.CrossRef
39.
go back to reference Salgado C, Mukherjee D, Quist M, Cero S. Anterior tibial artery pseudoaneurysm after ankle arthroscopy. Cardiovasc Surg. 1998;6(6):604–6.CrossRef Salgado C, Mukherjee D, Quist M, Cero S. Anterior tibial artery pseudoaneurysm after ankle arthroscopy. Cardiovasc Surg. 1998;6(6):604–6.CrossRef
40.
go back to reference Metzdorf A, Jakob RP, Petropoulos P, Middleton R. Arterial injury during revision total knee replacement a case report. Knee Surg Sports Traumatol Arthrosc. 1999;7(4):246–8.CrossRef Metzdorf A, Jakob RP, Petropoulos P, Middleton R. Arterial injury during revision total knee replacement a case report. Knee Surg Sports Traumatol Arthrosc. 1999;7(4):246–8.CrossRef
Metadata
Title
Prevalence and characteristics of the aberrant anterior tibial artery: a single-center magnetic resonance imaging study and scoping review
Authors
Julio Marin-Concha
Pablo Rengifo
Pedro Tapia
Daniel Kaiser
Timo Siepmann
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-021-04801-9

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