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Unusually Low Arcuate Artery in a Kenyan Cadaver

Thomas Amuti, Kamau Njonjo, Innocent Ouko, Ibsen Ongidi, Julius Ogeng’o

School of Medicine University of Nairobi

Correspondence to: Thomas Amuti, P.O Box 30197-00100, Nairobi; email: tomamuti@gmail.com

Summary

The arcuate artery is one of the two major branches of the dorsalis pedis artery that supply the dorsum of the foot including interdigital spaces. The artery’s origin varies but in almost all cases it branches in the proximal third of the dorsum of the foot. During routine dissection of the right foot in a black Kenyan, we encountered a case where the artery was located and branched in the distal third of the dorsum of the foot, at the level of the metatarsophalangeal joint. This is much more distal than previously reported in prevailing literature. This artery did not give off any dorsal metatarsal arteries but gave the digital arteries directly. The dorsalis pedis artery, lateral and medial tarsal arteries had normal course in this foot.

 

Keywords: Translational research; Dorsalis pedis artery; Integration; Arcuate artery

Ann Afr Surg. 2020; 17(1):45–47.

DOI: http://dx.doi.org/10.4314/aas.v17i1.12

Conflicts of Interest: None

Funding: None

© 2020 Author. This work is licensed under the Creative Commons Attribution 4.0 International License.

Introduction

The arcuate artery (AA) is usually a branch of the dorsalis pedis artery (DPA) that arises anterior to the lateral tarsal artery in the proximal foot at the tarsometatarsal joint. It passes laterally along the bases of the lateral four metatarsals, deep in the tendon of the extensor digitorum brevis. At the lateral aspect of the foot, it anastomoses with the lateral tarsal artery to form an arterial loop. It gives off the second through fourth dorsal metatarsal arteries which course between the toes, and each divides into two dorsal digital branches for the adjacent toe (1,2). Knowledge of the anatomical pattern of the arcuate artery is important for several reasons. First, it is critical during harvesting and application of myocutaneous flaps on the dorsum of the foot. Second, the distal part of the foot may constitute donor material for reconstructing the hand (3,4). Third, it minimizes inadvertent injury during diagnostic and interventional procedures (5). Fourth, it is an important component in the description and classification of the dorsalis pedis artery (6). Lastly, it is important for understanding the concept and application of “topographical” or angiosome-guided bypasses to foot ischemic wounds (7) and endovascular “wound directed” revascularization (8), for assessing and judging the anatomical distribution of angiosomes, and collateral circulation in macro- and microcirculation (9). Several variations involving origin, course and branching have been reported (1,4,10-13). High origin has also been reported in several studies (6,12,14,15). Low origin/ location, however, is seldom reported.

 

Case Report

During routine dissection of the dorsalis ped