RARE VARIANTS OF FORMATION OF COLLATERAL CIRCULATION IN PATIENTS WITH OBLITERATING ATHEROSCLEROSIS OF LOWER LIMB ARTERIES

Collateral circulation is very important in reconstructive surgery of atherosclerosis of lower limb arteries. In the international literature perforating veins are regarded as vessels that perforate fascia for connection of superficial and deep venous systems. The data of anatomical studies substantially enrich this definition: perforating veins do not simply provide functional unity of superficial and deep veins, but they are parts of тneurovascular bundles. According to the data of anatomical studies, perforating vein travels along an arterial branch and a nervous branch. Here, the arterial branch is rather large, and this peculiarity may be of clinical significance for patients with obliterating atherosclerosis of lower limb arteries. In the article, cases of formation of collaterals through perforating arteries of the hip and shin are described through which blood is supplied to the tibial nutrient arteries. It is of importance in angiology and vascular surgery, since arteries accompanying perforating veins, may form collaterals in patients with obliterating atherosclerosis of the lower limb arteries. Knowledge of the approach to management of patients with taking into account peculiarities of clinical anatomy of perforating neurovascular complexes permits to achieve better results of treatment.