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Evaluation of popliteal artery branching patterns and a new subclassification of the ‘usual’ branching pattern

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Abstract

Purpose

To determine the frequency of popliteal artery branching variations in a wide study cohort and to investigate the relationship between these variations and infrapopliteal peripheral arterial disease (PAD). A subclassification was proposed for the most encountered type I-A, utilizing tibio-fibular trunk (TFT) length.

Methods

A total number of 1184 lower extremity digital subtraction angiography (DSA) studies of 669 patients were evaluated. Following exclusion, 863 lower extremity DSA studies (431 right, 432 left) of 545 patients were enrolled. Popliteal artery branching type, patency of anterior tibial artery (ATA), fibular artery (FA) and posterior tibial artery (PTA) in each extremity and TFT length for type I-A extremities were recorded. Percentages of branching patterns, mean length and cut-off value of TFT and incidence of PAD in different types of branching were calculated.

Results

Type I-A was the most common type of branching (81.3%). Frequency of branching pattern variation was 18.7%, the most common variation category was category III (12.2%) and the most common variation type was type III-A (5.6%). ATA and PTA had higher percentages of PAD in extremities with variant branching types. Cut-off value of 3 cm for TFT length was proposed in order to subclassify type I-A.

Conclusions

Our study cohort presents a higher incidence of popliteal artery branching variations. Some branching variations might have effect on the involvement pattern of the infrapopliteal arteries by PAD. We propose a subclassification for type I-A; type I-A-S (TFT < 3 cm) and type I-A-L (TFT ≥ 3 cm) which might have impact on interventional procedures.

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Acknowledgements

We thank Emrah Celtikci, M.D. for technical editing of the manuscript.

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Authors and Affiliations

  1. Department of Radiology, Diskapi Yildirim Beyazit Egitim ve Arastirma Hastanesi, Radyoloji Klinigi, İrfan Baştuğ Cad., Altındağ, 06110, Ankara, Turkey

    Pinar Celtikci, Onur Ergun, Hasan Ali Durmaz, Isik Conkbayir & Baki Hekimoglu

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  1. Pinar Celtikci
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  2. Onur Ergun
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  3. Hasan Ali Durmaz
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  4. Isik Conkbayir
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Correspondence to Pinar Celtikci.

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No additional funding required for this study.

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All authors certify that they have no conflict of interest in the subject matter or materials discussed in this manuscript.

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Celtikci, P., Ergun, O., Durmaz, H.A. et al. Evaluation of popliteal artery branching patterns and a new subclassification of the ‘usual’ branching pattern. Surg Radiol Anat 39, 1005–1015 (2017). https://doi.org/10.1007/s00276-017-1834-y

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  • DOI: https://doi.org/10.1007/s00276-017-1834-y

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