Popliteal artery: anatomy and topography. Pathology of the popliteal artery

The popliteal artery is a fairly large vessel directly extending down the femoral artery. It is included in the structure of the neurovascular bundle, together with the same vein and the tibial nerve. Behind, from 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 leading canal, located under the half-membrane mouse, the popliteal artery lies at the bottom of the popliteal fossa first to the femur (directly to the popliteal surface), and further to the capsular shell of the knee joint.

The lower part of the artery contacts the popliteal muscle. It penetrates into the narrow space between the abdominals of the calf muscle that cover it. And reaching the edge of the soleus muscle, the vessel divides into the posterior and anterior tibial arteries.

The direction of the popliteal artery varies throughout its length:
• In the upper part of the popliteal fossa, the vessel is directed downward and outward.
• Beginning from the middle of the popliteal fossa, the popliteal artery is guided almost vertically downwards.

The branches of the popliteal artery

At its length the popliteal artery gives off a number of branches:
• Upper muscle branches.
• Upper lateral knee artery.
• Upper medial knee artery.
• The middle knee artery.
• Lower lateral knee artery.
• Lower medial knee artery.
• Calf arteries (two, rarely - more).

An aneurysm of the popliteal artery

According to medical statistics, this is the most common localization of aneurysms at the periphery: about 70% of peripheral aneurysms are localized in the popliteal region. The main cause of this pathological condition is considered to be atherosclerosis, since it is established as an etiological factor in the vast majority of patients with popliteal artery aneurysm.
An aneurysm of the popliteal artery develops practically regardless of age; The average age of patients is approximately 60 years, and the range of ages is from 40 to 90 years. Bilateral lesion is recorded in 50% of cases.
Much more often this disease affects men.
In the clinical picture, the symptoms of ischemic involvement of the distal limb are predominant; Can be added and the symptoms of compression of the nerve and vein (with compression of their aneurysm).
Complications:
• thrombosis of an aneurysm (aneurysmal cavity);
• Aneurysm rupture;
Calcification of aneurysm;
• compression of the nerve.
For diagnostics apply:
• angiography;
• CT scan.
For treatment, the popliteal artery ligation on both sides of the aneurysm (proximal and distal to it) with the subsequent shunting is most often performed.

Thrombosis of the popliteal artery

The predisposing factor for the formation of blood clots in the arteries is the damage to the internal surface of the vessels, the causes of which can be the following factors:
• Atherosclerotic deposits on the walls of blood vessels;
• hypertonic disease;
• diabetes;
• traumatization of the vascular wall;
• vasculitis.

Clinical manifestations

The thrombosis of the popliteal artery is manifested by the following symptoms:
• Severe tenderness in the limb, appearing sharply. Patients often compare her appearance with a stroke. In the future, pain can take a paroxysmal character; And the attack of pain leads to the appearance of sweat on the skin. Some relaxation of pain over time does not mean an objective improvement in the patient's condition.
• Pimple of the skin of the affected limb.
• Reducing 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 on the leg; Appearance of paresthesias.
• Limitation of mobility of the affected limb. Further mobility can be lost completely.
As a rule, the symptoms develop gradually, beginning with the onset of soreness.
In the absence of adequate measures, a complication in the form of gangrene may develop. This condition is characterized by a clear boundary between normal and necrotic tissues. In the future, the necrotic area is mummified.
The worst scenario is the infection of a necrotic site. This condition is diagnosed by rapidly developing hyperthermia, marked leukocytosis in the blood and the presence of ulcerous decay.