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Popliteal artery

The popliteal artery is the continuation of the femoral artery after it passes through the adductor hiatus into the popliteal fossa. It is the main arterial supply of the knee joint and leg, extending from the adductor canal to the lower border of the popliteus muscle, where it bifurcates into the anterior tibial artery and tibioperoneal trunk.

The popliteal artery is clinically significant because of its vulnerability to trauma, aneurysm formation, entrapment syndromes, and occlusive vascular disease. Its location within the popliteal fossa makes it a key structure for surgeons, radiologists, and vascular specialists.

Synonyms

  • Arteria poplitea

  • Posterior knee artery

Origin, Course, and Termination

  • Origin: Continuation of the femoral artery after passing through the adductor hiatus

  • Course:

    • Descends obliquely through the popliteal fossa

    • Lies deep within the fossa, closely applied to the posterior surface of the femur, joint capsule, and popliteus muscle

  • Termination: At the lower border of the popliteus muscle, it divides into:

    • Anterior tibial artery

    • Tibioperoneal trunk (which further divides into posterior tibial and peroneal arteries)

Relations

  • Anteriorly: Posterior surface of femur, posterior knee joint capsule, and popliteus muscle

  • Posteriorly: Popliteal vein (superficial to artery) and tibial nerve (most superficial)

  • Laterally: Biceps femoris tendon, lateral head of gastrocnemius, plantaris

  • Medially: Semimembranosus, semitendinosus, medial head of gastrocnemius

Branches

  • Muscular branches to gastrocnemius, soleus, and plantaris

  • Genicular branches forming the genicular anastomosis around the knee:

    • Superior lateral genicular artery

    • Superior medial genicular artery

    • Middle genicular artery

    • Inferior lateral genicular artery

    • Inferior medial genicular artery

  • Cutaneous branches supplying skin of posterior leg

Function

  • Provides the principal blood supply to the knee joint through its genicular branches

  • Supplies muscles of the popliteal fossa

  • Gives rise to all major arteries of the leg and foot through its terminal branches

Clinical Significance

  • Popliteal aneurysm: Most common peripheral aneurysm, can cause compression of vein/nerve

  • Popliteal artery entrapment syndrome (PAES): Caused by abnormal relationship between artery and surrounding muscles/tendons

  • Trauma: Susceptible in knee dislocations and fractures

  • Peripheral vascular disease: A common site of atherosclerotic occlusion

  • Imaging: Popliteal artery assessment is critical before vascular, orthopedic, or trauma surgery

MRI Appearance

T1-weighted images:

  • Artery lumen normally appears as a signal void (dark) due to flowing blood

  • Wall and surrounding fat seen clearly

T2-weighted images:

  • Lumen usually appears signal void

  • Thrombus or slow flow may show bright intraluminal signal

  • Aneurysm sac may show mixed intensities depending on thrombus age

STIR (Short Tau Inversion Recovery):

  • Suppresses fat, highlighting artery and adjacent soft tissues

  • Perivascular edema or inflammation appears bright

Proton Density Fat-Saturated (PD FS):

  • Vessel lumen is dark (flow void)

  • Pathology (thrombus, wall thickening) may appear as bright intraluminal or mural signal

T1 Fat-Sat Post-Contrast:

  • Artery enhances brightly and uniformly with gadolinium

  • Aneurysms or stenosis are well-demonstrated

  • Thrombus or dissection flaps remain non-enhancing

CT Appearance

Non-Contrast CT:

  • Artery appears as soft tissue density tubular structure

  • Calcified plaques seen as high-density foci in the wall

  • Acute thrombus may appear as hyperdense

Post-Contrast CT (CTA):

  • Artery enhances brightly and homogeneously

  • Demonstrates lumen, stenosis, aneurysm, or dissection

  • Useful for preoperative planning and trauma evaluation

MRA Appearance

  • Flow-sensitive sequences show arterial lumen as bright

  • Time-of-flight and contrast-enhanced MRA visualize course, stenosis, or aneurysm

  • Can assess genicular anastomosis and distal runoff

CTA Appearance

  • Provides high-resolution view of lumen and wall calcifications

CT VRT 3D image

Popliteal artery 3d image

MRI images

Popliteal artery axial cross sectional anatomy 3T MRI AI enhanced radiology anatomy image-img-00000-00000

MRI images

Popliteal artery mri images

MRI images

Popliteal artery

CT images

Popliteal artery ct axial image

CT images

Popliteal artery ct sagittal image