Rai Anurag, Chopra Jyoti, Irfan Amber, Roy Shubhajeet, Gourav Gourav, Parihar Anit, Kumar Shailendra
Thoracic Surgery, King George's Medical University, Lucknow, IND.
Anatomy, King George's Medical University, Lucknow, IND.
Cureus. 2024 Jun 25;16(6):e63092. doi: 10.7759/cureus.63092. eCollection 2024 Jun.
Comprehension of the intrucate anatomy and variations in the termination of the popliteal artery (PA) is increasingly essential for endovascular interventionists, plastic surgeons, vascular surgeons, and orthopedic surgeons, due to the rise in procedures like embolectomy, vascular grafting, free fibular flap surgery, and high-tibial osteotomy. Few studies from India have reported on the variant anatomy of PA termination, and none have used 128-slice tomography. This study aimed to observe the terminal branching pattern of the PA and the morphology of its terminal branches using 128-slice computed tomography angiography (CTA) and to analyze its relation to gender and laterality.
A retrospective review of CTA images of 181 lower extremities from 100 patients (137 males and 44 females), aged five to 75 years, was conducted.
The usual type I-A pattern was found in 75.69% of cases, while 24.31% exhibited variant patterns. Type III was the most common variation observed (19.34%), with type III-A being the most prevalent (11.05%). Types II-B and II-C were not observed. Among 84 bilaterally examined cases, 19.05% had unilateral variations and 15.48% had bilateral variations, with 8.33% showing bilaterally similar variations and 7.14% dissimilar variations. No significant difference in branching patterns was found between genders or sides. The mean length of the tibial-peroneal trunk (TPT) in the type I-A pattern was 3.00 ± 0.99 cm (right side: 3.21 ± 1.02 cm; left side: 2.82 ± 0.93 cm; males: 2.9 ± 1.00 cm; females: 3.37 ± 0.85 cm), with statistically significant differences between sides and genders. In the type II-A pattern, the mean TPT length was 7.16 ± 3.75 cm. An exceptionally long TPT (12.97 cm) was noted in one case of the III-B pattern.
There is a high prevalence of variation in the termination pattern of the PA. Knowledge of these variations is crucial for any interventions in this region to avoid postoperative vascular complications and reduce patient suffering.
由于诸如栓子切除术、血管移植术、游离腓骨瓣手术和高位胫骨截骨术等手术的增加，对于血管腔内介入医生、整形外科医生、血管外科医生和骨科医生而言，了解腘动脉（PA）复杂的解剖结构及其终止部位的变异变得越来越重要。印度很少有研究报道PA终止部位的变异解剖结构，且均未使用128层断层扫描。本研究旨在使用128层计算机断层血管造影（CTA）观察PA的终末分支模式及其终末分支的形态，并分析其与性别和侧别的关系。
对100例年龄在5至75岁患者（137例男性和44例女性）的181条下肢的CTA图像进行回顾性分析。
75.69%的病例呈现常见的I - A型模式，而24.31%表现出变异模式。III型是观察到的最常见变异（19.34%），其中III - A型最为普遍（11.05%）。未观察到II - B型和II - C型。在84例双侧检查的病例中，19.05%有单侧变异，15.48%有双侧变异，其中8.33%表现为双侧相似变异，7.14%为不同变异。性别和侧别之间在分支模式上未发现显著差异。I - A型模式下胫腓干（TPT）的平均长度为3.00±0.99 cm（右侧：3.21±1.02 cm；左侧：2.82±0.93 cm；男性：2.9±1.00 cm；女性：3.37±0.85 cm），侧别和性别之间存在统计学显著差异。在II - A型模式下，TPT的平均长度为7.16±3.75 cm。在一例III - B型模式中发现一条异常长的TPT（12.97 cm）。
PA终止模式的变异发生率很高。了解这些变异对于该区域的任何干预措施都至关重要，以避免术后血管并发症并减轻患者痛苦。
