High and low lateral approaches to the popliteal artery

Using a series of 20 dissections and two anatomic transverse sections of a lower limb, the authors investigated the lateral approaches to the poplitea l artery. The high lateral approach (above the knee) is not very aggressive and gives access to the retro-genicular part of the popliteal artery. Afte r cutaneous and fascial incision, a simple gap between the vastus lateralis and biceps femoris mm. allows easy exposure of the popliteal vessels after backward retraction of the sciatic nerve. The low lateral approach to the artery (below the knee) is very aggressive for the vessels, nerves, and lig aments of the area. It involves the resection of the upper fourth of the fi bula and the isolation and protection of the common peroneal nerve Neverthe less, these lateral approaches must be known and used when classic approach es (medial and posterior) are impossible.