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

Abstract

Background 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. Purpose To evaluate the variations and associated factors of popliteal artery branching by computed tomography angiography (CTA). Material and Methods 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. Results 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). Conclusion 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.

Variations of the popliteal artery in human fetuses: preliminary study

“…Adachi (1928) 10 analyzed adult specimens and defined trifurcation if the common trunk following the origin of the first branch was less than or equal to 0.5 cm in length, finding 0.8% cases of trifurcation. Kim (1989) 5 and Arayapithak (2023) 11 estimated a 2% frequency applying Adachi's rule but they analyzed angiograms. It is noteworthy that gender plays a significant role in branching variation.…”

“…It is noteworthy that gender plays a significant role in branching variation. 11 Morris (1960) 12 proposed a broader criterion for trifurcation, encompassing cases where the TFT is shorter than 1 cm (5.8%). This more practical classification may be preferable for vascular surgeons, although Adachi's criteria are anatomi-cally precise.…”