Variations in the branching pattern of the popliteal artery: a CT angiography study

Yıl 2021, Cilt: 15 Sayı: 3, 216 - 222, 31.12.2021

Nihal Gürlek Çelik , Zeliha Fazlıoğulları Ahmet Kağan Karabulut Alaaddin Nayman

Öz

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 important in the diagnosis and surgery of peripheral vascular diseases. For this reason, it is important to know the branching pattern of the popliteal artery. We believe that the classification system that we used will be useful in evaluating the different variations, particulary the branching levels of the branches of the popliteal artery.

Anahtar Kelimeler

computed tomography angiography, fibular artery, popliteal artery, tibial artery

Kaynakça

• Singla R, Kaushal S, Chabbra U. Popliteal artery branching pattern: a cadaveric study. European Journal of Anatomy 2012;16:157–62.
• Bettaiah A, Venkat S, Saraswathi G. A study of variations in the branching pattern of popliteal artery and its clinical perspective. International Journal of Research in Medical Sciences 2016;4:3584– 9.
• Kropman RHJ, Kiela G, Moll FL, de Vries JPPM. Variations in anatomy of the popliteal artery and its side branches. Vasc Endovascular Surg 2011;45:536–40.
• Drake LR, Vogl W, Mitchell AWM. Gray’s anatomy for students. Philadelphia (PA): Churchill Livingstone; 2015. p. 626–32.
• Woodley SJ, editor. Pelvic girdle and lower limb. In: Standring S, editor. Gray’s anatomy: the anatomical basis of clinical practice. 42nd ed. Edinburgh (Scotland): Elsevier; 2021. p. 1423–6.
• Senior HD. Abnormal branching of the human popliteal artery. Am J Anat 1929;44:111–20.
• Bardsley JL, Staple TW. Variations in branching of the popliteal artery. Radiology 1970;94:581–7.
• Day CP, Orme R. Popliteal artery branching patterns – an angiographic study. Clin Radiol 2006;61:696–9.
• Mauro MA, Jaques PF, Moore M. The popliteal artery and its branches: embryologic basis of normal and variant anatomy. AJR Am J Roentgenol 1988;150:435–7.
• Kim D, Orron DE, Skillman JJ. Surgical significance of popliteal arterial variants. A unified angiographic classification. Ann Surg 1989;210:776–81.
• Demirtaş H, Değirmenci B, Çelik AO, Umul A, Kara M, Aktaş AR, Parpar T. Anatomic variations of popliteal artery: evaluation with 128-section CT-angiography in 1261 lower limbs. Diagn Interv Imaging 2016;97:635–42.
• Mehta CR, Patel NR. A hybrid algorithm for Fisher’s exact test in unordered rxc contingency tables. Communication in Statistics – Theory and Methods 1986;15:387–403.
• Chow LC, Napoli A, Klein MB, Chang J, Rubin GD. Vascular mapping of the leg with multi-detector row CT angiography prior to free-flap transplantation. Radiology 2005;237:353–60.
• Mavili E, Dönmez H, Kahriman G, Özaşlamacı A, Özcan N, Taşdemir K. Popliteal artery branching patterns detected by digital subtraction angiography. Diagn Interv Radiol 2011;17:80–3.
• Ozgur Z, Ucerler H, Aktan Ikiz ZA. Branching patterns of the popliteal artery and its clinical importance. Surg Radiol Anat 2009;31:357–62.
• Olewnik L, ¸ab´towicz P, Podgórski M, Polguj M, Ruzik K, Topol M. Variations in terminal branches of the popliteal artery: cadaveric study. Surg Radiol Anat 2019;41:1473–82.
• Ouwendijk R, de Vries M, Pattynama PMT, van Sambeek MRHM, de Haan MW, Stijnen TS, van Engelshoven JMA, Hunink MGM. Imaging peripheral arterial disease: a randomized controlled trial comparing contrast-enhanced MR angiography and multi–detector row CT angiography. Radiology 2005;236:1094–103.
• Burrill J, Dabbagh Z, Gollub F, Hamady M. Multidetector computed tomographic angiography of the cardiovascular system. Postgrad Med J 2007;83:698–704.
• Heijenbrok-Kal MH, Kock MCJM, Hunink MGM. Lower extremity arterial disease: multidetector CT angiography meta-analysis. Radiology 2007;245:433–9.
• Yanık B, Bülbül E, Demirpolat G. Variations of the popliteal artery branching with multidetector CT angiography. Surg Radiol Anat 2015;37:223–30.
• Çalışır C, Şimşek S, Tepe M. Variations in the popliteal artery branching in 342 patients studied with peripheral CT angiography using 64-MDCT. Jpn J Radiol 2015;33:13–20.
• Kil SW, Jung GS. Anatomical variations of the popliteal artery and its tibial branches: analysis in 1242 extremities. Cardiovasc Intervent Radiol 2009;32:233–40.
• Lippert H, Pabst R. Arterial variations in man: classification and frequency. Munich: JF. Bergman-Verlag; 1985. 122p.
• Tomaszewski KA, Popieluszko P, Graves MJ, Pekala PA, Henry BM, Roy J, Hsieh WC, Walocha JA. The evidence-based surgical anatomy of the popliteal artery and the variations in its branching patterns. J Vasc Surg 2017;65:521–9.
• Wanderley APB, Brito GA, Rigolon LPJ, Lessa PF, Fernands RMP, Cisne R. Anatomical study of popliteal artery branching patterns and surgical considerations. International Journal of Anatomy and Research 2017;5:4410–3.
• Celtikci P, Ergun O, Durmaz HA, Conkbayır I, Hekimoglu B. Evaluation of popliteal artery branching patterns and a new subclassification of the ‘usual’ branching pattern. Surg Radiol Anat 2017;39:1005–15.
• Özaşlamacı A. Alt ekstremite manyetik rezonans anjiyografi incelemelerinde popliteal arter dallanma paternlerinin araştırılması: Kayseri Eğitim ve Araştırma Hastanesi Merkezi deneyimi. Türk Kardiyoloji Derneği Arşivi 2019;47:294–300.
• Oner S, Oner Z. Popliteal artery branching variations: a study on multidetector CT angiography. Sci Rep 2020;10:8147.