Variants of the popliteal artery terminal branches as detected by multidetector ct angiography (original) (raw)
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IOSR Journals , 2019
Introduction: The popliteal artery is the commonest blood vessel to get involved in peripheral artery aneurysm due to atherosclerosis and in entrapment syndrome. A detailed awareness on the anatomy of the terminal branches of the popliteal artery is associated with increased success rates of percutaneous surgical procedures as it allows suitable surgical planning. Aims: To evaluate variants of the popliteal artery (PA) terminal branches with 16 slice multidetector computed tomographic angiography. Materials and method: A total of 168 extremities of 200 patients undergoing a MD CTA examination were included in the study. Of these, 32 extremities were excluded due to popliteal artery thrombosis or amputation or having metallic implant. The terminal branching pattern of the PA was classified according to the classification scheme proposed by Kim. Results: In 168 extremities (91.6 %%) branching of PA occurred distal to the knee joint (Type I); in 8 cases (4.72%) PA branching was superior to the knee joint (Type II); and 6 cases (3.5%) of Type III. Among these types the most frequent branching patterns were Type IA 90.56%, Type IIA1 (2.36%), Type IIA2 (2.36%) and type III (2.36%). Conclusion: Variations in popliteal artery terminal branching pattern occurred in 9.44% of patients. Pre-surgical detection of these variations with MD CTA may help to reduce the risk of iatrogenic arterial injury by enabling a better surgical treatment plan.
Variations in the branching pattern of the popliteal artery: a CT angiography study
Anatomy
Objectives: The aim of this study was to reveal the different branching patterns of the popliteal artery by computed tomography angiography (CTA) in a large sample. Methods: CTA images of 1500 lower extremities of 750 patients (603 males, 147 females) with a mean age of 56.4±19.6 were evaluated retrospectively. The variations in the branching pattern of the popliteal artery and the frequency of these variations were examined and classified under three main types. Results: Type I–A was observed in 1422 extremities (94.8%) and noted as the most common branching pattern of the popliteal artery; Type I–B and Type I–C was observed in 39 extremities (2.6%); Type II in 37 extremities (2.4%) and Type III in 2 extremities (0.1%). The bilateral incidence of Type I–A was 90.8%. The incidence of bilateral variation was 0.4% for Type I–B and 0.1% for Type II–B. No statistically significant difference was found in terms of side and gender. Conclusion: Evaluation of lower extremity arteriograms is...
Popliteal artery branching patterns detected by digital substraction angiography
Diagnostic and interventional radiology, 2010
A wareness of the anatomical variability determined by embryonic vascular development is important for radiologists and surgeons. Popliteal arterial variation may have clinical implications for vascular grafting, direct surgical repair, transluminal angioplasty, or embolectomy. Moreover, differentiating occlusion or arterial injury from variation depends on the clinician's knowledge of variations (1-10). Therefore, we aim to describe popliteal arterial variations. Materials and methods The femoral angiograms of 535 extremities (270 right, 265 left) in 350 consecutive patients who provided informed consent for the digital subtraction angiography (DSA) procedure were retrospectively examined. Of these, 226 limbs were evaluated bilaterally, and 83 limbs were evaluated unilaterally. The branching patterns were classified according to the system used by Kim et al. (Figs. 1a, 2a, 3a) (1). A normal level of popliteal branching (below the level of the tibial plateau) was classified as Type I. Type I was further divided into Type IA, in which the anterior tibial artery (AT) is the first branch, and the peroneal artery (PR) and posterior tibial artery (PT) arise from the tibioperoneal trunk (Fig. 1b); IB, in which there is no true tibioperoneal trunk and AT, PT, and PR arise within 0.5 cm (Fig. 1c); and IC, in which the PT is the first branch and AT and PR arise from the anterior tibioperoneal trunk (Fig. 1d). High division of the popliteal artery (at or above the level of the tibial plateau) was classified as Type II. This classification was further divided into Type IIA1, in which the AT arises above the knee and has a normal course (Fig. 2b); IIA2, in which the AT arises above the knee and has an initial medial curve (Fig. 2c); IIB, in which the PT is the first branch and arises above the knee joint, and the AT and PR have a common trunk (Fig. 2d); IIC, in which the PR is the first branch and arises above the knee joint, and the AT and PT have a common trunk; and IID, which involves high division of the popliteal artery with a trifurcation pattern and an AT with an initial medial course and a distal lateral course (Figs. 2e and 2f). Hypoplastic or aplastic branching with altered distal supply was classified as Type III. This group was further divided into Type IIIA, in which the PT is hypoplastic and the distal PT is replaced by the PR (Figs. 3b and 3c); Type IIIB, in which the AT is hypoplastic and the dorsalis pedis (PD) is replaced by the PR (Figs. 3d and 3e); and Type IIIC, in which the AT and PT are hypoplastic and the distal PT and DP are replaced by the PR (Figs. 3f and 3g).
High level termination of popliteal artery just distal to hiatus magnus - a case report
2012
During routine dissection for first MBBS students on 65 years donated embalmed male cadaver in the Department of Anatomy, K.J.Somaiya Medical College, we observed the high origin of anterior tibial artery from the popliteal artery proximal to the popliteus muscle. The anterior tibial artery ran downward on the posterior surface of the popliteus muscle. The posterior peroneotibial trunk distal to the tendinous arch of soleus muscle divides into the posterior tibial and the peroneal arteries. The further course of anterior, posterior tibial and peroneal arteries was normal. The photographs of the variations were taken for proper documentation and ready reference. There were no associated neuromuscular variations found in same specimen. The right lower limb of the same cadaver was normal. Conclusion - The arthroscopic knee surgery is a convenient and preferred surgical procedure. The knowledge of branching pattern of popliteal artery is important for surgical interventions in the popli...
2017
Popliteal artery injury is the most disastrous intraoperative complication during total knee replacement. This study aims to determine the mean distance between the popliteal artery (PA) and the tibial plateau in normal and osteoarthritic patients who underwent Dual Energy CT Angiography (CTA) of the lower limb. Materials and Methods: All CTA lower limb examinations from January 2013 to October 2014 were retrospectively reviewed. The distance between the PA the tibial plateau distance and the thickness of popliteus muscle were electronically measured. We used modified Kellgren and Lawrence's Classification to grade the osteoarthritis in patients who underwent CT examinations regardless of symptoms. Results: There were a total of 126 patients who underwent CTA (93 males and 33 females). 54 of them were Malays, 47 Indians, and 24 Chinese. The mean age of patients was 58 years (range 16 to 92). The mean PA-to-tibial plateau distance was 9.9 mm for the right lower limb (range 2.5 mm...
Annals of Vascular Diseases, 2020
Recently a hinge point or the maximum bending stress point of the popliteal artery was identified when the knee bends using a lateral view dynamic angiography and a correlation between the lateral view angiography with the extended limb angiography to predict the potential location of the hinge point was defined. A hinge point has been correlated to stent fracture. These findings allowed us to develop a dynamic classification of the popliteal artery. The dynamic classification is useful for endovascular procedures in the popliteal artery. Cultural aspects of our patient population must be considered previous to the endovascular treatment of the popliteal artery, especially to the Japanese culture, which is commonly observed sitting posture such as seiza ().
The Anatomical Study of Popliteal Artery and Its Variations
2017
Address for Correspondence: Dr. J. Sujitha Jacinth, Assistant professor, Department of Anatomy, RMMCH, Annamalai University, Chidambaram, India. E-Mail: sujitha_jaf@rediffmail.com Introduction & aim: Anatomical variations in the arterial system are very common. In spite of advanced invasive techniques, knowledge of variations still remains limited. One such artery showing variations is the popliteal artery. Limb-threatening sequelae ensue from its damage. The aim of the study encompasses gaining knowledge on the anatomy of Popliteal artery with respect to its commencement, termination, branching pattern & its relation with surrounding structures mainly the muscles in the Popliteal fossa with a view of helping surgeons from various fields while performing surgery in this region. Comparison with results from previous studies on the popliteal artery was also planned. Materials and Methods: The study was carried out in 50 lower limbs of 25 well embalmed cadavers of South Indian origin i...
Revista Brasileira de Ortopedia (English Edition), 2015
Objective: To analyze and describe the distance from the popliteal artery to three specific areas of the proximal region of the tibia, with the knee extended, by means of magnetic resonance. Methods: Images of 100 knees of patients who underwent magnetic resonance examinations were analyzed. The location of the popliteal artery was measured in three different areas of the posterior proximal region of the tibia. The first measurement was made at the level of the knee joint (tibial plateau). The second was 9 mm distally to the tibial plateau. The third was at the level of the anterior tuberosity of the tibia (ATT). Results: The distances between the popliteal artery and the tibial plateau and ATT region were significantly greater in males than in females. The distances between the popliteal artery and the regions 9 mm distally to the tibial plateau and the ATT were significantly greater in the age group over 36 years than in the group ≤36 years. Conclusion: Knowledge of the anatomical position of the popliteal artery, as demonstrated through magnetic resonance studies, is of great relevance in planning surgical procedures that involve the knee joint. In this manner, devastating iatrogenic injuries can be avoided, particularly in regions that are proximal to the tibial plateau and in young patients.