Kim D, Orron D E, Skillman J J
Department of Radiology, Harvard Medical School, Boston, Massachusetts.
Ann Surg. 1989 Dec;210(6):776-81. doi: 10.1097/00000658-198912000-00014.
Distal popliteal arterial variations may influence the success of femorodistal popliteal and tibial arterial reconstructions. Two patients whose bypass procedures were initially unsatisfactory because of a poor choice for anastomosis stimulated a review of variations in the distal popliteal artery in 1000 femoral arteriograms. The popliteal arterial anatomy could be assessed in 605 extremities and the tibial arterial anatomy in 495 extremities. Seventy-five variant cases were identified. Normal branching of the popliteal artery was present in 92.2%. Among the 7.8% incidence of variants, the majority (72%) were either high origin of the anterior tibial artery or a trifurcation pattern. Of variant patterns to the foot (5.6%), the most common was that in which the supply to the distal posterior tibial artery arose from the peroneal artery. We propose a unified classification of the popliteal and tibial arterial variations that encompasses both anatomic areas. Variant arterial supply to the foot can be suspected when the infrapopliteal vessels show a hypoplastic or aplastic anterior or posterior tibial artery and compensatory hypertrophy of the peroneal artery. Knowledge of these variants is important to angiographers and vascular surgeons.
腘动脉远端变异可能会影响股腘动脉和胫动脉重建手术的成功率。两名患者因吻合部位选择不当，最初的搭桥手术效果不理想，这促使我们对1000例股动脉造影中的腘动脉远端变异情况进行回顾性研究。605例肢体可评估腘动脉解剖结构，495例肢体可评估胫动脉解剖结构。共识别出75例变异病例。92.2%的病例腘动脉分支正常。在7.8%的变异发生率中，大多数（72%）为胫前动脉高位起源或三叉分支模式。在足部变异模式（5.6%）中，最常见的是胫后动脉远端供血来自腓动脉。我们提出了一种涵盖腘动脉和胫动脉两个解剖区域变异的统一分类方法。当腘动脉以下血管显示胫前动脉或胫后动脉发育不全或缺如，以及腓动脉代偿性肥大时，应怀疑足部存在变异动脉供血。了解这些变异情况对血管造影师和血管外科医生很重要。
