Artery Transposition Using Indocyanine Green for Tarsal Tunnel Decompression.
Artery transposition
Idiopathic
Indocyanine green
Posterior tibial artery
Tarsal tunnel syndrome
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
14
05
2020
revised:
02
06
2020
accepted:
04
06
2020
pubmed:
17
6
2020
medline:
29
12
2020
entrez:
17
6
2020
Statut:
ppublish
Résumé
Surgery for idiopathic tarsal tunnel syndrome (TTS) is of limited effectiveness or ineffective. Using indocyanine green video angiography (ICG-VA), we treated idiopathic TTS by posterior tibial artery (PTA) decompression from the posterior tibial nerve (PTN) and evaluated postoperative patency of the PTA. We treated 12 patients (12 feet) with idiopathic TTS by PTA decompression from the PTN and transposed its location. Age range of patients was 70-87 years (mean 77.9 years); all patients were operated on under local anesthesia. After a 2-cm skin incision, the flexor retinaculum was resected, and the PTA was decompressed from the PTN. It was then sutured to the flexor retinaculum for decompression and to prevent compression recurrence. ICG-VA was used to confirm the absence of PTA flow disturbance and to inspect the vasa nervorum of the PTN. We encountered no intraoperative or postoperative complications. Postoperatively, ICG-VA confirmed blood flow in the PTA and intactness of the vasa nervorum in all cases. One patient required adjustment of PTA position. All patients reported symptom improvement. Our surgical method of treating idiopathic TTS under ICG-VA monitoring is simple, safe, and effective.
Sections du résumé
BACKGROUND
Surgery for idiopathic tarsal tunnel syndrome (TTS) is of limited effectiveness or ineffective. Using indocyanine green video angiography (ICG-VA), we treated idiopathic TTS by posterior tibial artery (PTA) decompression from the posterior tibial nerve (PTN) and evaluated postoperative patency of the PTA.
METHODS
We treated 12 patients (12 feet) with idiopathic TTS by PTA decompression from the PTN and transposed its location. Age range of patients was 70-87 years (mean 77.9 years); all patients were operated on under local anesthesia. After a 2-cm skin incision, the flexor retinaculum was resected, and the PTA was decompressed from the PTN. It was then sutured to the flexor retinaculum for decompression and to prevent compression recurrence. ICG-VA was used to confirm the absence of PTA flow disturbance and to inspect the vasa nervorum of the PTN.
RESULTS
We encountered no intraoperative or postoperative complications. Postoperatively, ICG-VA confirmed blood flow in the PTA and intactness of the vasa nervorum in all cases. One patient required adjustment of PTA position. All patients reported symptom improvement.
CONCLUSIONS
Our surgical method of treating idiopathic TTS under ICG-VA monitoring is simple, safe, and effective.
Identifiants
pubmed: 32540297
pii: S1878-8750(20)31300-0
doi: 10.1016/j.wneu.2020.06.042
pii:
doi:
Substances chimiques
Indocyanine Green
IX6J1063HV
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
142-148Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.