MORPHOLOGIC STRUCTURE OF THE PEDAL ARCH AND ITS RELATIONSHIP TO PATENCY OF CRURAL VASCULAR RECONSTRUCTION

  • 1 January 1981
    • journal article
    • research article
    • Vol. 152  (5) , 645-648
Abstract
Pedal arch integrity can be determined morphologically and functionally. The former is accessible by contrast studies and intraoperative catheterization and the latter, by flow studies and observation of graft patency. The roentgen image of an intact pedal arch corresponds to the anatomic plantar arch. Arch studies [64] obtained by adequate intraoperative arteriography were categorized as intact, deficient or inadequate or absent. Patency of crural reconstructions was obtained in 18 of 24 patients with intact arches as compared to 15 of 32, P < 0.06, when the arch was deficient. Crural reconstruction in the face of an inadequate or absent arch resulted in predictable graft closure. Qualitative factors, i.e., size, Ca and stenotic lesions, are integrally related to over-all graft performance even with intact arches. The deficient arch is still a surgical challenge in tibial and peroneal reconstruction.

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