Variations in Anatomy of the Popliteal Artery and Its Side Branches

Abstract

Knowledge of anatomic variations of the popliteal artery is essential for the management of peripheral vascular disease and in orthopedic surgery. The aim of this study was to perform an overview of the literature describing variations of the popliteal artery. To identify relevant literature, we performed a systematic search on MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews. We included 4 studies of anatomic dissections and 11 radiologic retrospective series, comprising 7671 limbs, and a variation in popliteal branching was seen in almost 10%. The 3 most frequent variations in branching are a high origin of the anterior tibial artery, the trifurcation of the anterior tibial artery, peroneal artery, and posterior tibial artery, and a hypoplastic or aplastic posterior tibial artery. Awareness of the terminal branching pattern of the popliteal artery before intervention enhances the planning for successful operations and may reduce the incidence of serious, unexpected arterial injury.

Anatomical Study of Popliteal Artery Branching Patterns and Surgical Considerations

“…The only value of distance D found was equal to 1cm. The frequency of the pattern IA (80.95%) is lower than all frequencies considered in the review by Kropman et al (7) . For this pattern, Kim et al obtained 92.2%.…”

“…The most remarkable, however, is not the most common pattern but the second most prevalent pattern. Trifurcation (Figure 1) is one of the most prevalent variations [6,7,20,21]. Its frequency in the literature ranges from 6.0% (Davies et al, 1989) [22] to 1.5% (Kil & Jung, 2009) [8].…”

“…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].…”

Ischemic Ulcer Healing: Does Appropriate Flow Reconstruction Stand for All That We Need?

“…The presence of one anatomical popliteal variation (i.e. high origin of the anterior tibial trunk) on one side may indicate possible ipsilateral foot vessel abnormalities in about 21% of cases [107,109], and similar contralateral leg variants in 48% of instances [109,110]. Concomitant acquired arterial flow disturbances were also cited in lower leg ischemic presentations, most of them accompanying the diabetic neuro-ischemic foot syndrome [34,53,59].…”

“…Following two recent metaanalysis gathering 7671 [107] or 5790 inferior limbs [108], and two "in vivo" analogous angiographic observations [109,110], native atypical leg arteries were described in utmost 7.9-10% individuals out of general population [107][108][109][110]. Among these variants, hypoplastic or aplastic posterior tibial artery was encountered in 3.3% cases, whereas the anterior tibial trunk was absent in about 1.5% of instances [108].…”