However, in ACECS, the anterior tibial artery is the affected arterial source; its distal continuation, dorsalis pedis
, may be normal due to augmented collateralization from the peroneal artery in a patient with CECS.
His pulse rate was 96/min with diminished right radial pulse and both femorals, popliteals, dorsalis pedis
and posterior tibial artery.
Ultrasound of the left foot shows loss of normal triphasic waveform and diminished amplitude of the dorsalis pedis
artery waveform (Figure 3).
PAD was defined as presence of at least two of the following factors: ABI < 1, absence of both dorsalis pedis
and posterior tibial pulses at palpation in one or both legs, and intermittent claudication.
The right calf was cold, tense, and popliteal, dorsalis pedis
and posterior tibial pulses were absent.
The left foot was warm with a good ultrasound signal for the Arteria tibialis posterior pulse but no signal for the Arteria dorsalis pedis
Normally the flow in the distal tibialis posterior artery and dorsalis pedis
artery is high-resistance triphasic flow (Fig.
Commonly, arteries used for catheterization include the radial, ulnar, brachial, axillary, femoral, posterior tibial, and dorsalis pedis
Pulsation of all peripheral pulses--femoral artery, popliteal artery, anterior tibial artery, posterior tibial artery as well as dorsalis pedis
artery was palpable.
Clinical manifestations of the affected limb revealed absence of dorsalis pedis
and anterior tibial in all the 30 patients, absence of posterior tibial in 28 patients and popliteal in 20 patients.
The dorsalis pedis
and posterior tibial pulses were not palpable due to extreme swelling.
3 When reporting measurement, remember that congenitally about 20-30% of the population lack a dorsalis pedis
pulse and less than 10% of the population lack a posterior tibial pulse (Sacks, et al.