Collateral artery pathways of the femoral and popliteal artery

Rombout R. Kruse, Denise E. Doomernik, Kasper V. Maltha, Jan G.M. Kooloos, Tamas Kozicz, Michel M.P.J. Reijnen

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background The role of collateral artery circulation in the lower limb is under debate but clinically relevant, particularly when using covered stents for occlusive disease. Covered stents seem to outperform nitinol stents in extensive disease, but collaterals could be essential in case of acute thrombosis. In the present study, we describe the collateral pathways of the deep and superficial femoral artery (DFA, SFA) and the popliteal artery (PA), observed in human cadavers. Methods Ten fresh frozen cadaver legs were selected. The SFA and DFA were separately cannulated and injected with a different colored latex mixture simultaneously. After curing of the latex, the circulation was dissected thus visualizing the main arteries and their collateral vessels. The process was photographed and recorded, and collateral pathways were analyzed using a standardized vessel segmentation. The upper leg was divided in three regions, that is, the femoral triangle (F), the adductor canal (H), and the popliteal fossa (P) that, in turn, were split in three segments (1, 2, and 3, from proximal to distal). Results Overall, 113 collateral vessels were found; 69 originated from the DFA, 34 from the SFA, and 10 from the PA. The majority of collaterals originating from the DFA terminated in the SFA (57%). Fifty-six of 113 collaterals (50%) ended in either the distal adductor channel (H3) or the proximal PA (P1). Another 28 collateral arteries (25%) had their origin in this segment (H3, P1) and mostly connected to the P2 and P3 segments. Forty-three collaterals of the DFA and H3 segment had a direct or indirect connection to below the knee muscles. Conclusions The majority of collaterals originate from the DFA, and the greater part of all collaterals has a connection with the H3-P1 segment. This observation may have clinical implications in the planning of endovascular procedures.

Original languageEnglish (US)
Pages (from-to)45-52
Number of pages8
JournalJournal of Surgical Research
Volume211
DOIs
StatePublished - May 1 2017
Externally publishedYes

Fingerprint

Popliteal Artery
Femoral Artery
Stents
Arteries
Latex
Cadaver
Leg
Collateral Circulation
Endovascular Procedures
Thigh
Lower Extremity
Knee
Thrombosis
Muscles

Keywords

  • Cadaver
  • Collateral artery
  • Deep femoral artery
  • Popliteal artery
  • Postmortal
  • Superficial femoral artery

ASJC Scopus subject areas

  • Surgery

Cite this

Kruse, R. R., Doomernik, D. E., Maltha, K. V., Kooloos, J. G. M., Kozicz, T., & Reijnen, M. M. P. J. (2017). Collateral artery pathways of the femoral and popliteal artery. Journal of Surgical Research, 211, 45-52. https://doi.org/10.1016/j.jss.2016.11.068

Collateral artery pathways of the femoral and popliteal artery. / Kruse, Rombout R.; Doomernik, Denise E.; Maltha, Kasper V.; Kooloos, Jan G.M.; Kozicz, Tamas; Reijnen, Michel M.P.J.

In: Journal of Surgical Research, Vol. 211, 01.05.2017, p. 45-52.

Research output: Contribution to journalArticle

Kruse, RR, Doomernik, DE, Maltha, KV, Kooloos, JGM, Kozicz, T & Reijnen, MMPJ 2017, 'Collateral artery pathways of the femoral and popliteal artery', Journal of Surgical Research, vol. 211, pp. 45-52. https://doi.org/10.1016/j.jss.2016.11.068
Kruse, Rombout R. ; Doomernik, Denise E. ; Maltha, Kasper V. ; Kooloos, Jan G.M. ; Kozicz, Tamas ; Reijnen, Michel M.P.J. / Collateral artery pathways of the femoral and popliteal artery. In: Journal of Surgical Research. 2017 ; Vol. 211. pp. 45-52.
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abstract = "Background The role of collateral artery circulation in the lower limb is under debate but clinically relevant, particularly when using covered stents for occlusive disease. Covered stents seem to outperform nitinol stents in extensive disease, but collaterals could be essential in case of acute thrombosis. In the present study, we describe the collateral pathways of the deep and superficial femoral artery (DFA, SFA) and the popliteal artery (PA), observed in human cadavers. Methods Ten fresh frozen cadaver legs were selected. The SFA and DFA were separately cannulated and injected with a different colored latex mixture simultaneously. After curing of the latex, the circulation was dissected thus visualizing the main arteries and their collateral vessels. The process was photographed and recorded, and collateral pathways were analyzed using a standardized vessel segmentation. The upper leg was divided in three regions, that is, the femoral triangle (F), the adductor canal (H), and the popliteal fossa (P) that, in turn, were split in three segments (1, 2, and 3, from proximal to distal). Results Overall, 113 collateral vessels were found; 69 originated from the DFA, 34 from the SFA, and 10 from the PA. The majority of collaterals originating from the DFA terminated in the SFA (57{\%}). Fifty-six of 113 collaterals (50{\%}) ended in either the distal adductor channel (H3) or the proximal PA (P1). Another 28 collateral arteries (25{\%}) had their origin in this segment (H3, P1) and mostly connected to the P2 and P3 segments. Forty-three collaterals of the DFA and H3 segment had a direct or indirect connection to below the knee muscles. Conclusions The majority of collaterals originate from the DFA, and the greater part of all collaterals has a connection with the H3-P1 segment. This observation may have clinical implications in the planning of endovascular procedures.",
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AU - Doomernik, Denise E.

AU - Maltha, Kasper V.

AU - Kooloos, Jan G.M.

AU - Kozicz, Tamas

AU - Reijnen, Michel M.P.J.

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N2 - Background The role of collateral artery circulation in the lower limb is under debate but clinically relevant, particularly when using covered stents for occlusive disease. Covered stents seem to outperform nitinol stents in extensive disease, but collaterals could be essential in case of acute thrombosis. In the present study, we describe the collateral pathways of the deep and superficial femoral artery (DFA, SFA) and the popliteal artery (PA), observed in human cadavers. Methods Ten fresh frozen cadaver legs were selected. The SFA and DFA were separately cannulated and injected with a different colored latex mixture simultaneously. After curing of the latex, the circulation was dissected thus visualizing the main arteries and their collateral vessels. The process was photographed and recorded, and collateral pathways were analyzed using a standardized vessel segmentation. The upper leg was divided in three regions, that is, the femoral triangle (F), the adductor canal (H), and the popliteal fossa (P) that, in turn, were split in three segments (1, 2, and 3, from proximal to distal). Results Overall, 113 collateral vessels were found; 69 originated from the DFA, 34 from the SFA, and 10 from the PA. The majority of collaterals originating from the DFA terminated in the SFA (57%). Fifty-six of 113 collaterals (50%) ended in either the distal adductor channel (H3) or the proximal PA (P1). Another 28 collateral arteries (25%) had their origin in this segment (H3, P1) and mostly connected to the P2 and P3 segments. Forty-three collaterals of the DFA and H3 segment had a direct or indirect connection to below the knee muscles. Conclusions The majority of collaterals originate from the DFA, and the greater part of all collaterals has a connection with the H3-P1 segment. This observation may have clinical implications in the planning of endovascular procedures.

AB - Background The role of collateral artery circulation in the lower limb is under debate but clinically relevant, particularly when using covered stents for occlusive disease. Covered stents seem to outperform nitinol stents in extensive disease, but collaterals could be essential in case of acute thrombosis. In the present study, we describe the collateral pathways of the deep and superficial femoral artery (DFA, SFA) and the popliteal artery (PA), observed in human cadavers. Methods Ten fresh frozen cadaver legs were selected. The SFA and DFA were separately cannulated and injected with a different colored latex mixture simultaneously. After curing of the latex, the circulation was dissected thus visualizing the main arteries and their collateral vessels. The process was photographed and recorded, and collateral pathways were analyzed using a standardized vessel segmentation. The upper leg was divided in three regions, that is, the femoral triangle (F), the adductor canal (H), and the popliteal fossa (P) that, in turn, were split in three segments (1, 2, and 3, from proximal to distal). Results Overall, 113 collateral vessels were found; 69 originated from the DFA, 34 from the SFA, and 10 from the PA. The majority of collaterals originating from the DFA terminated in the SFA (57%). Fifty-six of 113 collaterals (50%) ended in either the distal adductor channel (H3) or the proximal PA (P1). Another 28 collateral arteries (25%) had their origin in this segment (H3, P1) and mostly connected to the P2 and P3 segments. Forty-three collaterals of the DFA and H3 segment had a direct or indirect connection to below the knee muscles. Conclusions The majority of collaterals originate from the DFA, and the greater part of all collaterals has a connection with the H3-P1 segment. This observation may have clinical implications in the planning of endovascular procedures.

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KW - Postmortal

KW - Superficial femoral artery

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