Flexions of the Popliteal Artery and the Culture Could Challenge the Outcomes of the Endovascular Procedures

Recently a hinge point or the maximum bending stress point of the popliteal artery was identified when the knee bends using a lateral view dynamic angiography and a correlation between the lateral view angiography with the extended limb angiography to predict the potential location of the hinge point was defined. A hinge point has been correlated to stent fracture. These findings allowed us to develop a dynamic classification of the popliteal artery. The dynamic classification is useful for endovascular procedures in the popliteal artery. Cultural aspects of our patient population must be considered previous to the endovascular treatment of the popliteal artery, especially to the Japanese culture, which is commonly observed sitting posture such as “seiza (正座).”