Alternative Approaches To The Popliteal Artery And Its Trifurcation

Aims. The aim of this study was to describe the surgical approaches that can be used as alternatives to the popliteal artery (PA) and to its trifurcation, excluding the medial and posterior paths, which are considered to be classical procedures. It also outlines the advantages and disadvantages of each approach and their most important indications. Results and conclusions. The alternative paths include the above- or below-the-knee lateral path with or without resection of the fibula, the total medial path and the medial path of the proximal anterior tibial artery (ATA). They are not generally used very often because most situations can be resolved by means of endovascular techniques or by medial and posterior approaches. The most important indications for a lateral approach to the PA would be infection, radiotherapy, re-interventions or extensive scarring on the medial side. The need to examine the second part of the PA would indicate the total medial path and indications for the medial path of the proximal ATA would be an insufficient length of the graft, sequential bypasses and infection of the anterior tibial compartment. The most notable disadvantages include possible injury to the common peroneal nerve, instability of the knee and the fact that less is known about these alternative techniques.