Variations in the Clinical Anatomy of the Femoral and Popliteal Vessels

Abstract

Objective: The aim of this study was to assess the topography of the femoral and popliteal vessels focusing mainly on the venous variants, in patients with chronic venous disease (CVD). Materials and Methods: Duplex ultrasonography (DUS) was performed on 200 patients with varicose veins (VVs) and 253 patients with postthrombotic syndrome (PTS). In addition, an anatomical dissection was performed on 30 amputated lower extremities, without signs of CVD. Results: Duplication of the femoral vein (FV) was found in 14% of patients with VVs. Multiple FV trunks were identified in 42% of patients with PTS. One patient had a developmental anomaly with a hypoplastic FV and dilated deep FV. Two trunks of the popliteal vein (PV) below the knee level were detected in 83.3% of cases during anatomical dissection, in 87.5% of cases in patients with VVs, and in 90.1% of cases in PTS subjects during DUS. In 98.2% of cases, popliteal artery (PA) had a typical bifurcation. One patient was presented with a duplication of PA above the level of the knee. In 1.8% of cases, the PA was divided into an anterior tibial and peroneal artery. Conclusion: This study found variant anatomy in the FV and PV, which is frequent, with major changes occurring in patients with PTS. Variant anatomy of the PA was also found and is considered uncommon, occurring in less than 2% of cases.