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利用CT血管造影术对膝关节周围股动脉和腘动脉的走行进行研究:对手术干预的意义

Navigation of femoral and popliteal artery around the knee with CT angiography: implications for surgical interventions.

作者信息

Kazemi Seyyed-Morteza, Keyhani Sohrab, Sadighi Mehrdad, Hosseininejad Seyyed-Mohsen

机构信息

Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Orthopedic Surgery, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Surg Radiol Anat. 2023 Nov;45(11):1515-1523. doi: 10.1007/s00276-023-03241-5. Epub 2023 Sep 21.

Abstract

PURPOSE

Uncertainty about the exact position of the femoral and popliteal arteries in the medial thigh and posterior knee might increase vascular complications in surgical procedures. This study aimed to document femoral and popliteal arteries in the medial thigh and around the knee to assist surgeons in developing safer surgical approaches.

METHODS

The study included 120 patients-180 lower limbs-who underwent CT angiography (CTA) of the lower extremity. The distance from the femoral artery to the anterior border, midsagittal axis, and posterior border of the femur and the popliteal artery to the medial, lateral, and midpoint posterior cortex of the proximal tibia was measured in two- and three-dimensional CTA images.

RESULTS

The femoral artery was found to be on average 236.93 ± 29.61 mm, 195.34 ± 26.12 mm, and 146.28 ± 33.18 mm away from the adductor tubercle at the anterior, midsagittal axis, and posterior borders of the femur, correspondingly. The popliteal artery was to be located on average 5.40 ± 2.50 mm posterior to the midpoint of the plateau tibia at the joint line.

CONCLUSION

Considering the mentioned femoral/popliteal artery distances to the femur and proximal tibia would direct surgeons to the safe zones for more accurate surgical approaches in the medial thigh and around the knee when performing osteotomies, knee arthroplasty, arthroscopy, and trauma surgeries, to reduce possible vascular damages.

LEVEL OF EVIDENCE

IV.

摘要

目的

股动脉和腘动脉在内侧大腿和膝关节后方的确切位置存在不确定性,这可能会增加外科手术中的血管并发症。本研究旨在记录内侧大腿和膝关节周围的股动脉和腘动脉,以帮助外科医生制定更安全的手术入路。

方法

本研究纳入了120例患者(180条下肢),这些患者接受了下肢CT血管造影(CTA)检查。在二维和三维CTA图像上测量股动脉到股骨前缘、矢状轴和后缘的距离,以及腘动脉到胫骨近端内侧、外侧和后皮质中点的距离。

结果

发现股动脉在股骨前缘、矢状轴和后缘处与内收肌结节的平均距离分别为236.93±29.61mm、195.34±26.12mm和146.28±33.18mm。腘动脉位于关节线处胫骨平台中点后方平均5.40±2.50mm处。

结论

考虑到上述股动脉/腘动脉与股骨和胫骨近端的距离,在进行截骨术、膝关节置换术、关节镜检查和创伤手术时,可引导外科医生进入安全区域,以便在内侧大腿和膝关节周围采取更精确的手术入路,从而减少可能的血管损伤。

证据级别

四级。

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