The Feasibility of Popliteal Vein Anterior Puncture in Supine Position: A View of Clinical Applied Anatomy

Objective: This study observed the anatomical relation between the popliteal vein and surrounding structures via computed tomography venography (CTV) to determine the optimal position for popliteal vein puncture in the supine position. We then conducted a small follow-up clinical trial to confirm our findings. Methods: The data on CTV of the lower extremities were collected from 112 patients. The anatomical type, diameter, and confluent location of the popliteal vein were observed to determine the location and angle of the appropriate approach for anterior popliteal vein puncture. The successful rate and complications of the anterior puncture of the popliteal vein were analyzed in 52 patients. Results: In the popliteal vein autopsy, most are the 2 branching veins converged into the popliteal vein. The medial channel was generally large. The popliteal vein was located on the medial side of the artery at the tuberosity tibia level and gradually turned to the back and lateral side during an upward course. When the lateral edge of the tibia overlapped the medial edge of the vein, the coverage area between the popliteal vein and the artery was 37.2%, which was relatively small. The coverage area is suitable for anterior approach puncture. The success rate of this method was 100%. No complications were reported after follow-up for 12 months. Conclusion: The projected angle was left or right anterior oblique, and the lateral edge of the tibia overlapped the medial edge of the popliteal vein. The puncture angle should be as medial as possible. Clinical Impact In this study, the anatomical type, diameter and intersection position of popliteal vein through popliteal fossa were observed to determine the appropriate approach position and angle of popliteal vein puncture in supine position to provide experience for the future treatment of deep venous thrombosis.Based on this theory, a small follow-up clinical trial was conducted to confirm the safety of this method.