The popliteal artery is a fairly large vessel that directly continues down the femoral artery. It lies as part of the neurovascular bundle, along with the vein of the same name and the tibial nerve. Behind, from the side of the popliteal fossa, the vein lies closer to the surface than the artery; and the tibial nerve is even more superficial than the blood vessels.
Location and topography
Beginning at the lower aperture of the afferent canal, located under the semimembranous mice, the popliteal artery adjoins at the bottom of the popliteal fossa, first to the femur (directly to the popliteal surface), and later to the capsular membrane of the knee joint.
The lower part of the artery is in contact with the popliteal muscle. It penetrates into the narrow space between the bellies of the gastrocnemius muscle, which cover it. And having reached the edge of the soleus muscle, the vessel is divided into the posterior and anterior tibial arteries.
The direction of the popliteal artery changes along its length:
• In the upper part of the popliteal fossa, the vessel has a downward and outward direction.• Starting from the level of the middlepopliteal fossa, the popliteal artery is directed almost vertically downwards.
Branches of the popliteal artery
During its course, the popliteal artery gives off a number of branches:
• Superior muscular branches.
• Superior lateral genicular artery.
• Superior medial genicular artery.
• Middle genicular artery.
• Inferior lateral genicular artery.
• Inferior medial genicular artery.• Sural arteries (two; rarely more).
Popliteal artery aneurysm
According to medical statistics, this is the most common localization of aneurysms in the periphery: about 70% of peripheral aneurysms are localized in the popliteal region. Atherosclerosis is considered to be the main cause of this pathological condition, since it is established as an etiological factor in the vast majority of patients with popliteal artery aneurysm.
A popliteal artery aneurysm develops almost regardless of age; the average age of patients is approximately 60 years, and the range of ages is from 40 to 90 years. Bilateral lesions are recorded in 50% of cases.
Significantly more often this disease affects men.
The clinical picture is dominated by symptoms of ischemic lesions of the distal limb; symptoms of compression of the nerve and vein (when they are compressed by the aneurysm) can also be added. calcification of the aneurysm;
• nerve compression.
For diagnosis use:
•angiography;
• computed tomography.
The most common treatment is ligation of the popliteal artery on both sides of the aneurysm (proximal and distal to it) followed by bypass surgery.
Popliteal artery thrombosis
A predisposing factor for the formation of blood clots in the arteries is damage to the inner surface of blood vessels, the causes of which may be the following factors:
• atherosclerotic deposits on the walls of blood vessels;
• hypertension;
• diabetes mellitus;
• traumatization of the vascular wall;• vasculitis.
Clinical manifestations
Thrombosis of the popliteal artery is manifested by the following symptoms:
• Severe pain in the limb, appearing abruptly. Patients often compare its appearance with a blow. In the future, the pain may take on a paroxysmal character; moreover, an attack of pain leads to the appearance of sweat on the skin. Some weakening of pain over time does not mean an objective improvement in the patient's condition.
• Paleness of the skin of the affected limb.
• Decrease in the temperature of the skin of the affected limb.
• Appearance of thickening on the leg; its location coincides with the level of localization of the thrombus.
• Decrease, and later - disappearance of sensitivity in the leg; the appearance of paresthesia.
• Restriction of the mobility of the affected limb. In the future, mobility may be completely lost.
As a rule, symptoms develop gradually, starting with the onset ofsoreness.
In the absence of adequate measures, a complication in the form of gangrene may develop. This condition is characterized by the presence of a clear boundary between normal and necrotic tissues. In the future, the necrotic area is mummified. The worst case scenario is the infection of the necrotic area. This condition is diagnosed by rapidly developing hyperthermia, severe leukocytosis in the blood and the presence of ulcerative decay.
