Branching Pattern Of Popliteal Artery Research Articles

Popliteal artery branching variations on computed tomography angiography of 1542 lower limbs and its associated factors.

The identification of popliteal artery branching variation is of anatomical importance for surgical and endovascular procedures in the posterior region of the knee and below. To evaluate the variations and associated factors of popliteal artery branching by computed tomography angiography (CTA). CTA of the lower extremities of 1542 lower limbs in 771 patients (513 men and 258 women) were retrospectively reviewed to assess the popliteal artery branching patterns. The patient's sex, side of lower limbs, and population were recorded and evaluated for their association with popliteal artery branching patterns. P < 0.05 was considered to indicate statistical significance. Variations in the branching of the popliteal artery were recorded in 9.3% of patients. The three most common variations were found to be hypoplastic-aplastic posterior tibial artery (PT) (3.6%), trifurcation (2.0%), and hypoplastic-aplastic anterior tibial artery (0.8%). A new pattern was detected in 2 (0.1%) cases, which were described as double PTs. Statistically significant differences were noted in the proportion of variation branching between the male and female groups (odds ratio = 1.52; 95% confidence interval = 1.07-2.16; P = 0.02). The findings on popliteal variational branching patterns in the present study were in conformance to previous reports. Our study identified a novel variation of popliteal artery branching, which has not been mentioned in the literature so far. Sex was found to be an associated factor of branching variation.

Multidetector Computed Tomography Angiographic Evaluation of Anatomical Variations in Popliteal Artery Branching: A Retrospective Study from Northern India

Introduction: The popliteal artery branching pattern has multiple variations which have implications in outcomes of various surgical procedures. Amongst cadaveric, Computed Tomography (CT) angiographic and Digital Subtraction Angiographic (DSA) studies, Multidetector Computed Tomography (MDCT) Angiography provides a comprehensive, quick and efficient evaluation of the popliteal arterial anatomy along with surrounding structures and related pathologies of the vascular and non-vascular structures. Aim: To evaluate the patterns of popliteal artery division on MDCT angiography of lower limb in patients presenting to a tertiary medical institute in Northern India. Materials and Methods: This retrospective descriptive study was conducted in Department of Radiology at Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India (tertiary care medical institute of Northern India). Patients presenting for a period of one year from April 2021 to March 2022 were included in the study. The MDCT angiographic findings of 152 patients who were evaluated for various illness including peripheral vascular disease, popliteal arterial aneurysms and trauma were analysed. The branching pattern of popliteal artery was evaluated according to the classification system provided by Kim DU et al., Morphometric analysis of popliteal artery including diameter was also done. The imaging based data was collected and analysed by two radiologists. Chi-square test was used for statistical analysis. Results: The mean age of the patients was 54.18 years with males predominance of 110 (72.37%). Amongst the 304 limbs available for evaluation, the data from six limbs could not be assessed due to atherosclerotic blockage in four patients, extensive calcification in one patient and amputation in one patient. Hence, 298 limbs were evaluated on MDCT angiography for the pattern of branching of popliteal artery. Type IA was the most common pattern of division seen in 268 limbs (89.93%). Out of 298, 30 limbs showed variant anatomy, with unilateral variation in 18 patients and bilateral variation in six patients. Type III pattern (n=12, 4.03%) was more common than Type II pattern (n=11, 3.6%) in the study group. Conclusion: The knowledge of variations of popliteal arterial division and meticulous evaluation is essential to provide a successful roadmap for therapeutic measures.

The congenital popliteal vasculature patterns in fibular free flap reconstruction by means of surgical anatomy in cadavers

Fibular free flap (FFF) is frequently used for reconstruction requiring vascularized bone. Thus, understanding its vasculature variation is crucial. This study investigates the popliteal artery branching variations in Thai cadavers and compares them with previous studies. One hundred and sixty-two legs from 81 formalin-embalmed cadavers were dissected. The popliteal artery branching patterns were classified. The previous data retrieved from cadaveric and angiographic studies were also collected and compared with the current study. The most common pattern is type I-A (90.7%). For the variants, type III-A was the majority among variants (6.2%). Type IV-A, hypoplastic peroneal artery, was found in one limb. A symmetrical branching pattern was found in 74 cadavers. Compared with cadaveric studies, type III-B and III-C are significantly common in angiographic studies (p = 0.015 and p = 0.009, respectively). Type I-A is most common according to previous studies. Apart from this, the prevalence of type III-A variant was higher than in previous studies. Furthermore, type III-B and III-C are more frequent in angiographic studies which might be from atherosclerosis. Thus, if the pre-operative CTA policy is not mandatory, the patients at risk for atherosclerosis and population with high variants prevalence should undergo pre-operative CTA with cost-effectiveness consideration.

A cadaveric study of variations in the branches of popliteal artery in South Indian population

Introduction: Popliteal artery gains much importance because of the clinical conditions encountered and the surgeries carried out in the region of popliteal fossa. The variations in the branching pattern of popliteal artery is observed and studied by many as the knowledge of its variations will be of relavence during the vascular surgeries, fasciocutaneous flaps and surgeries of knee. Materials and Methods: Present study is conducted on 50 lower limb specimens belonging to the department of Anatomy of Karuna medical college by detailed dissection and tracing of all its branches. Results and Discussion: Two out of 50 specimens showed the presence of superficial sural artery accompanying the sural nerve very rare but very important one. No variation in the course of the popliteal artery was encountered. Trifurcation of popliteal artery was not encountered in the present study. Conclusion: The present study shows the importance of the superficial cutaneous branch of the popliteal artery with respect to the fasciocutaneous flaps an important finding for the plastic surgeons & surgeries where fasciocutaneous free and pedicled flaps can be raised over the superficial cutaneous branches of Popliteal artery. Keywords: Superficial sural artery, Fasciocutaneous flaps, Superficial sural artery flap.

A STUDY OF THE ARTERIAL VARIATIONS IN THE POPLITEAL REGIONS, ARE THEY SYMMETRICAL OR NOT?

Objective: To assess the prevalence of the arterial variations in the popliteal regions and the symmetrical characteristic of the popliteal artery branching patterns in both knees of all subjects. Methodology: 77 subjects (154 knees) were prospectively studied using colour Doppler ultrasonography in this descriptive and cross-sectional study. No subject had anomalies of the lower limbs or history of previous lower limb surgery. Subjects with cardiovascular disease were excluded from this study. Results: Prevalence of the popliteal artery variations was 4.5%. The two variants (type I-B and type II-A) were seen in both knees. There were 5 subjects who had at least one variant in either side of their knees. Two subjects had type II-A occurred bilaterally in both knees while 3 other subjects had unilateral pattern of type I-B in combination with type I-A in their knees. Conclusion: Symmetrical and non-symmetrical pattern can be seen in the population depending on the popliteal artery branching pattern

Investigation of popliteal artery branching patterns in magnetic resonance angiography examinations: Experience of Kayseri Education and Research Hospital

This study was designed to evaluate variations in popliteal artery (PA) distal branching observed in lower extremity magnetic resonance angiography (MRA) images. A total of 576 lower extremity MRA examinations that were performed consecutively between 2008 and 2012 in a single hospital were retrospectively evaluated. In all, 767 lower extremity images of 425 patients were included in the study and 151 examinations that were inappropriate were excluded. A bilateral evaluation was conducted of 342 lower extremities, and 83 lower extremities were evaluated unilaterally. The anatomical variations in the PA branching patterns were classified and assessed, and the results were evaluated with other studies that have examined PA distal branching variations with digital subtraction angiography and computed tomography angiography. The most frequently seen pattern was type IA (normal pattern), detected in 613 (80%) extremities. Variations in PA branching were depicted in 154 (20%) extremities and 733 (95.6%) limbs had a normal level of PA branching. Type II variations, with a high division of the PA (at or above the level of the tibial plateau), were seen in 34 (4.4%) extremities. Type III variations were observed in 87 (11.4%) extremities. Of the 342 bilaterally evaluated patients, 251 (73%) had a bilaterally symmetrical pattern. Type IA was the most frequently encountered bilaterally symmetrical pattern. MRA examination can be used as an alternative to digital subtraction angiography for the evaluation of PA branching patterns.

Evaluation of popliteal artery branching patterns and a new subclassification of the 'usual' branching pattern.

To determine the frequency of popliteal artery branching variations in a wide study cohort and to investigate the relationship between these variations and infrapopliteal peripheral arterial disease (PAD). A subclassification was proposed for the most encountered type I-A, utilizing tibio-fibular trunk (TFT) length. A total number of 1184 lower extremity digital subtraction angiography (DSA) studies of 669 patients were evaluated. Following exclusion, 863 lower extremity DSA studies (431 right, 432 left) of 545 patients were enrolled. Popliteal artery branching type, patency of anterior tibial artery (ATA), fibular artery (FA) and posterior tibial artery (PTA) in each extremity and TFT length for type I-A extremities were recorded. Percentages of branching patterns, mean length and cut-off value of TFT and incidence of PAD in different types of branching were calculated. Type I-A was the most common type of branching (81.3%). Frequency of branching pattern variation was 18.7%, the most common variation category was category III (12.2%) and the most common variation type was type III-A (5.6%). ATA and PTA had higher percentages of PAD in extremities with variant branching types. Cut-off value of 3cm for TFT length was proposed in order to subclassify type I-A. Our study cohort presents a higher incidence of popliteal artery branching variations. Some branching variations might have effect on the involvement pattern of the infrapopliteal arteries by PAD. We propose a subclassification for type I-A; type I-A-S (TFT < 3cm) and type I-A-L (TFT ≥ 3cm) which might have impact on interventional procedures.

An angiographic study in terminal branching pattern of popliteal artery and its clinical connotation

An angiographic study in terminal branching pattern of popliteal artery and its clinical connotation

Popliteal artery branching patterns detected by digital substraction angiography

To describe the popliteal and distal branching patterns detected by digital subtraction angiography. The popliteal branching patterns were analyzed in 535 extremities (270 right, 265 left). Of these, 226 limbs were evaluated bilaterally, while 83 were evaluated unilaterally. The branching patterns were classified according to the level of branching and the presence of hypoplasia or aplasia of the distal branches. Four hundred and seventy-two (88.1%) limbs had a normal level of popliteal artery branching. Type IA was the most frequently encountered pattern. High division of the popliteal artery was seen in 30 (5.6%) limbs. Type IIA was the most frequently encountered pattern among these limbs. Type IIC was not seen. We encountered a new pattern characterized by high division of the peroneal artery with a trifurcation pattern and an anterior tibial artery with a proximal medial course and a distal lateral course. We called this pattern Type IID. Thirty-three (6.1%) limbs exhibited hypoplasia/aplasia of the distal branches. Type IIIA was the most frequently encountered pattern among these limbs. Variations that occur in nearly 10% of patients should be understood because they may affect the choice of management strategy.

Branching patterns of the popliteal artery and its clinical importance

The aim of this study was to evaluate the popliteal artery branching patterns and related measurements. A cadaveric study in forty lower limbs was performed to improve the understanding of anatomy of the popliteal artery and its main branches. Normal branching of the popliteal artery was present in 36 specimens (90%). High origin of the anterior tibial artery was seen in two specimens (5%). The bifurcation was at the level of proximal border of popliteus, but the posterior tibial artery originated directly from the popliteal artery in one specimen (2.5%). Trifurcation pattern with no trunk was observed in one specimen (2.5%). We believe that a review of the anatomic characteristics of the popliteal artery and its branches will be beneficial for the surgical approaches and the choice of suitable arterial graft sites.

Popliteal artery branching patterns—an angiographic study

To analyse the variations in branching patterns of the popliteal artery and infrapopliteal vessels using angiography. Femoral angiograms of 1037 lower limbs in 568 patients were examined to assess the popliteal artery branching pattern. Variations of the infrapopliteal vessels supplying the foot were assessed in 662 limbs from the same cohort of patients. Nine hundred and forty-one (90.7%) limbs had the usual branching pattern with anterior tibial artery (AT) arising first followed by the tibial-peroneal trunk (TPT), which then gives rise to the posterior tibial (PT) and peroneal (PR) arteries. Variations in popliteal branching pattern were seen in 96 (9.3%) limbs. The commonest variation is high origin of the AT in 47 (4.5%) limbs or trifurcation of the popliteal artery in 33 (3.2%) limbs with AT, PT and PR arising together with no true TPT. The course of AT with high origin either anterior or posterior to popliteus was almost equal [25 (2.4%) or 22 (2.1%) limbs, respectively]. Eleven limbs (1.1%) had high origin of PT and two (0.2%) had a high origin of the PR. Six hundred and fifty-five (99%) limbs had normal infrapopliteal vessels. Seven (1%) had hypoplasia-aplasia of the infrapopliteal vessels. Five (0.8%) limbs had a hypoplastic PT with the remaining 2 (0.2%) having either a hypoplastic-aplastic AT or hypoplasia-aplasia of both AT and PT. Variations in the branching of the popliteal artery occur in about 10% of patients. Knowledge of these variations is important because of the potential consequences for the management of peripheral vascular disease.