Bilateral Absent Fibular (Peroneal) Arteries

Background: The most common branching pattern in the lower extremity is the popliteal artery branching into the anterior tibial artery and tibiofibular trunk. The documentation of aplastic fibular artery is quite rare in the scientific literary world and is mostly found incidentally in unrelated procedures. The absence of a fibular artery can lead to compensatory changes in the posterior tibial artery. Case Presentation: The bilateral absent fibular arteries described in this case report were found in a 75-year old female during routine cadaver dissection at The University of North Texas Health Science Center. The donor had no known complications from this anatomical variation and died from unrelated causes. In this case, the popliteal artery is seen branching into the anterior and then posterior tibial arteries. There is no formation of the tibiofibular trunk nor the fibular artery. The posterior tibial artery supplies the gastrocnemius and other muscles of the posterior compartment of the leg. In addition, the posterior tibial artery fills the role of the absent fibular artery by sending compensatory branches to the lateral compartment of the leg to supply fibularis longus, brevis, and lateral foot. These unique branches from the posterior tibial artery allow for blood supply to the lateral lower extremity and lateral foot musculature. This variation was found bilaterally in the cadaver. Conclusion: This case illustrates a unique presentation of a cadaver with an unusual anatomic variant: bilateral missing fibular arteries.