INVESTIGATION OF VESSELS OF LEG IN ATYPICAL ANATOMY OF TIBIAL VESSELS USING DUPLEX ULTRASOUND ANGIOGRAPHY

Background. Knowledge of vascular anatomy is the basis for precise diagnosis and, accordingly, of treatment. At the same time, variant anatomy complicates this task, as it requires a non-standard algorithm. Among all areas of the lower extremities, the shin presents the greatest difficulty because of small diameter of vessels and a large muscular mass. Therefore, the aim of this work was to determine the incidence of the variant of the development of the shin vessels with predomination of fibular vessels and to develop an algorithm for ultrasound examination in atypical anatomy. Materials and Methods. A morphological study of the venous system in 85 lower extremities was carried out, as well as analysis of the results of ultrasound examination of the vessels of the lower extremities in 2000 patients (aged from 18 to 90) who underwent routine examination in an outpatient setting. Ultrasound examination was performed on Samsung Sonoace X8, Siemens Acuson Сypress, Saoyte My Lab Alfa devices. A linear sensor with 7 to 12 MHz frequency, a convex sensor with 2 to 5 MHz frequency were used. Results. According to the data of anatomical preparation, the incidence of the structural variant of the tibial vessels with predomination of the fibular vascular bundle was 2.35% of cases. In all cases, the posterior tibial vessels were hypoplastic and were traced to the middle third of the leg. According to ultrasound data, an atypical variant of the structure of the tibial vessels was noted in 2.9% of cases. In 1.7% of cases, the posterior tibial vascular bundle was completely absent (in 0.35% of cases bilaterally), and in 1.2% of cases, the posterior tibial vascular bundle was hypoplastic and was traced to the middle third of the leg (in 0.3% cases bilaterally). Conclusion. The variant of development of tibial vessels with predomination of the fibular vascular bundle is quite rare. Ultrasound examination helps precisely and reliably identify this variant of the structure of blood vessels.