Embolectomy. Popliteal Artery Below the Knee, Fig

Popliteal Artery Below the Knee, Fig. 7 A,B.

a A sterile pillow or pad is placed under the distal femur. The incision is placed 1 or 2 cm posterior to the medial border of the tibia, starting at the tibial tuberosity and extending 10–12 cm distally. Subcutaneous fat and fascia are sharply divided, with caution to the greater saphenous vein.

b The popliteal fossa is reached by retracting the gastrocnemius muscle dorsally. The deep fascia is divided and the artery usually easier to identifiy. Occasionally, pes anserinus must be divided for adequate exposure. The popliteal artery is often located just anterior to the nerve and in close contact with the popliteal vein and crossing branches from concomitant veins. If it is necessary to expose the more distal parts of the popliteal artery, the soleus muscle has to be divided and partly separated from the posterior border of the tibia.

Fig. 7 A. Exposure of popliteal artery below the knee

Fig. 7 B. Exposure of popliteal artery below the knee

It is beyond the scope of this book to cover the technique for vascular reconstructions. But because embolectomy from the groin with balloon catheters (known as Fogarty catheters) is one of the most common emergency vascular operations in a general surgical clinic and may be performed by surgeons not so familiar with vascular surgery.

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