Surgical Significance of Popliteal Arterial Variants

Abstract

Distal popliteal arterial variations may influence the success of femorodistal popliteal and tibial arterial reconstructions. Two patients whose bypass procedures were initially unsatisfactory because of a poor choice for anastomosis stimulated a review of variations in the distal popliteal artery in 1000 femoral arteriograms. The popliteal arterial anatomy could be assessed in 605 extremities and the tibial arterial anatomy in 495 extremities. Seventy-five variant cases were identified. Normal branching of the popliteal artery was present in 92.2%. Among the 7.8% incidence of variants, the majority (72%) were either high origin of the anterior tibial artery or a trifurcation pattern. Of variant patterns to the foot (5.6%), the most common was that in which the supply to the distal posterior tibial artery arose from the peroneal artery. We propose a unified classification of the popliteal and tibial arterial variations that encompasses both anatomic areas. Variant arterial supply to the foot can be suspected when the infrapopliteal vessels show a hypoplastic or aplastic anterior or posterior tibial artery and compensatory hypertrophy of the peroneal artery. Knowledge of these variants is important to angiographers and vascular surgeons.

A study of variations in the branching pattern of popliteal artery and its clinical perspective

“…Moreover differentiating occlusion or arterial injury from variation depends upon clinician's knowledge of variation 4 . With the advent of newer diagnostic techniques like angiography, duplex ultrasound, MRA, CT angiogram, it is necessary to be aware of these variations to prevent misinterpretation of test results.…”

“…4 With this perspective, the present study was undertaken, wherein the popliteal artery and its branching pattern was studied in detail.…”

Anatomical Study of Popliteal Artery Branching Patterns and Surgical Considerations

“…The aim of this survey is to describe and quantify these variations comparing the results to the data found in literature based on the Kim et al classification [6].…”

“…peroneal artery (PR) [6][7][8][9][10][11][12][13][14][15]. However, it is possible to find variations with significant freque-ncy and its knowledge is critical whereas it guides a good medical practice for vascular surgeons and interventional radiologists [3,5,6,[14][15][16][17][18][19].…”

“…The specimens were studied by gross anatomy dissection according to the Helsinki Declaration and approved by the Scientific Council. According to the classification of Kim et al (6) , were considered the distance between medial tibial plateau and arising at first popliteal artery branch (distance A), the posterior tibial-peroneal trunk length (distance B), the distance between first popliteal branch and its bifurcation (distance C) and the anterior tibial-peroneal trunk length (distance D). For such measurements a digital caliper rule was utilized.…”