Importance of the arteriographic anatomy of the descending genicular artery and sural arteries in patients with atherosclerotic occlusion of the popliteal artery

Abstract

Bypasses to the descending genicular artery (DGA) or the medial sural artery (MSA) have been performed with acceptable rates of midterm success. the arteriographic appearance of the DGA, the MSA, and the lateral sural artery (LSA) was described and the applicability of bypass to these vessels was investigated. the arteriograms of 45 patients who had occlusion of the below-knee popliteal artery were analyzed to determine the presence, dominance, and extension of collaterals for each perigeniculate branch, which were used to assess the applicability of a perigeniculate bypass. A dominant perigeniculate artery was found in 26 arteriograms and corresponded to 13 DGAs, 9 MSAs, and 4 LSAs. of 14 applicable perigeniculate bypasses, 2 would be an obligatory bypass and 12 would be an alternative to a conventional infrapopliteal bypass. Although rarely an obligatory solution, a bypass to a perigeniculate branch artery represents a valuable alternative.