The anterior tibial artery is located in the lower leg, extending from… Popliteal fossa Just behind the knee, along the tibia and fibula, which are the main bones in the lower leg. It is a branch of the popliteal artery that carries oxygenated blood to the anterior (forward-facing) part of the leg.
At the point where the artery crosses the front of the ankle, it becomes the dorsal artery of the foot and supplies blood to the top of the foot. A number of health conditions can affect the artery, including pain and swelling that occurs with constriction known as compartment syndrome. It can also provide clues to underlying health conditions, such as peripheral artery disease.
Anatomy and function
The anterior tibial artery passes through a strong connective tissue called the interosseous membrane after it separates from the popliteal artery and travels down the leg from the knee.
After passing through this membrane, it runs down between two muscles in the front of the lower leg, the tibialis anterior and the extensor digitorum longus, before crossing the front of the ankle joint.
When passing through the interosseous membrane, this artery divides into a number of branches, including:
- Anterior recurrent tibial artery: The anterior recurrent tibial artery passes upward through the tibialis anterior muscle (an important muscle in the lower leg near the tibia).
- Perforated branches: These branches travel behind the extensor digitorum longus muscle, penetrating deep connective tissue (also known as fascia) on their way to the skin of the lower leg.
- Muscular branches: A number of small arteries branch from the anterior tibial artery, which supplies the muscles of the lower leg.
- Anterior medial malleolar artery: This artery connects to the posterior tibial artery, emerges about 5 cm above the ankle joint, and passes behind the ankle tendons to end at the inner ankle.
- Anterior lateral malleolus artery: This artery passes under the tendons of the extensor digitorum longus as well as the peroneus tertiary muscle, a muscle found in the front of the lower leg (tibia). It eventually joins the branches of other arteries.
- Dorsal foot artery: Dorsal artery of the foot arises as The anterior tibial artery reaches the front of the ankle. It extends to the upper surface of the foot before dividing into a number of its own branches.
The anterior tibial artery delivers oxygenated blood to the front part of the lower leg, called the “anterior chamber.” It supplies the muscles, nerves, and other tissues in the lower leg as well as the skin. At the ankle, the dorsal foot artery serves the top of the foot.
Anatomical differences
More than 90% of people have no anatomical difference in the anterior tibial artery, but it is absent or underdeveloped in some people. Normally, the peroneal artery makes up for the difference in terms of blood supply.
In rare cases, the anterior and posterior tibial arteries are absent, and alternative blood flow pathways are needed.
Associated conditions
Many diseases can severely affect the anterior tibial artery. It can include:
- Anterior tibial artery entrapment: When an artery is compressed by other structures (usually muscles or tendons), blood flow decreases, causing pain in the lower leg, which is generally caused by activities that use those leg muscles and improves with rest. This occurs most often with the popliteal artery, but it can occur with the anterior tibial artery as well.
- Exertional compartment syndrome: This condition, also called chronic compartment syndrome, is due to increased pressure in the compartment during exercise when muscle volume increases but the connective tissue covering does not expand. This can occur in athletes and often resolves with rest or other non-surgical treatments, but may require surgery.
- Acute compartment syndromeTrauma or injury may cause acute compartment syndrome. Swelling or bleeding in the compartment increases pressure in the compartment, causing pain, swelling, and possible nerve damage. It is considered a medical emergency and requires surgery to correct.
- Peripheral artery disease: In this condition, blood flow is restricted due to plaque buildup and hardening of the artery. It is more common in older people but those who have been diagnosed with diabetes, high blood pressure, high cholesterol or a history of smoking may be at greater risk. Treatment may be needed to restore blood flow and protect against infection, clots, or even amputation.
Identification of the anatomical variant may also be important. For example, magnetic resonance imaging (MRI) studies can find a variant called anomalous anterior tibial artery (AATA). This information is useful when planning a total knee replacement or other surgical procedures.
treatment
Treatment of conditions affecting the anterior tibial artery depends on the specific diagnosis and severity. For example, surgery may be needed to treat compartment syndrome or entrapment syndrome.
Peripheral artery disease is treated with a combination of treatments that include:
- Lifestyle modifications, including walking exercise programs
- Cholesterol medications
- High blood pressure medications
- Blood thinners
- Devices, such as stents, are designed to keep blood vessels open
- Arterial bypass and other surgeries
Keep in mind that peripheral artery disease is a risk factor for heart attacks and other cardiovascular diseases.
summary
The anterior tibial artery supplies blood to the front of the lower leg and becomes the dorsal foot artery at the ankle, in addition to branching into other vessels serving the lower leg. The anterior tibial artery itself branches first from the popliteal artery, located behind the knee.
A number of conditions, including compartment syndrome and peripheral artery disease, can affect the health and function of the anterior tibial artery. Talk with your healthcare provider about any symptoms affecting your lower leg that may be related, including pain and swelling.
