Editing Arterial exposures (section)

== '''Anterior tibial artery''' ==

* Arises from the lateral aspect of the below-knee popliteal artery and immediately passing through the interosseous membrane, before entering the anterior compartment. Therefore the first 2-3cm are generally inaccessible for bypass and have significant atheromatous disease.
* For above-knee bypasses, need to tunnel carefully either subcutaneously or through the interosseous membrane (can result in kinking/thrombosis)
*
* Proximal/middle third ATA:
** Vertical incision on anterolateral calf, centred on the location of planned anastomosis (palpate cleft between tibialis anterior and extensor digitorum longus muscles approximately at the midpoint between the fibula and tibia and incise directly over the cleft, starting 3cm distal to fibular head)
** Incise overlying fascia in line with skin incision (careful of common peroneal nerve)
** Blunt finger dissection to get in between tibialis anterior and EDL (be careful of small ATA branches)
** Deep in the cleft at the level of the interosseous membrane, the ATA and ATV are usually identified. Often the vein is anterior to the artery.
**
* Distal half
** Similar to above
** Best exposed at the ankle just proximal to the malleoli and flexor retinaculum