Popliteal artery anatomy: An angiographic description of variants

Purpose: Variations of the terminal branches of the popliteal artery (PA) are not uncommon and manifest by a wide range of pathology. Medical professionals thus require knowledge and insight into popliteal anatomic arterial variability for effective medical practice. This study aimed to use computed tomography angiography (CTA) to describe variations of the terminal branches of the PA in a cohort not yet known to be affected by any acquired arterial abnormalities. Materials & methods: Hundred and seventy-four bilateral lower extremity CTA scans of patients that underwent angiographic evaluation at our research affiliated hospital, with a total of 348 limbs were retrospectively reviewed after ethical approval was granted. The different anatomical terminal branching patterns of the PA were analysed and classified and the length of the tibiofibular trunk (TFT) were recorded. Results: The most prevalent PA branching pattern was the “usual” Type I-A pattern, found in 301 limbs (86.49%). The TFT length in all Type I-A patterns varied greatly and ranged between 7 and 127 mm, with the mean TFT length equating to 30.99 mm ± 16.46. Variant branching's occurred in 47 limbs (13.51%). Most notably, a rare anomaly in the form of a bilateral hypoplastic fibular artery variation was observed in one scan, named as the newly classified Type III-D pattern. Conclusion: Recognizing variations in the terminal branching patterns of the PA is important in vascular and orthopaedic surgical procedures of the lower extremity. Identification of these variations prior to procedural intervention can facilitate the planning of optimal treatment strategies and improve patient outcomes