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Deep femoral artery: A new point of view based on cadaveric study

H Claassen1, O Schmitt2, M Schulze2

  • 1Department of Anatomy, Rostock University Medical Center, Gertrudenstraße 9, D-18057 Rostock, Germany; Institute of Functional and Clinical Anatomy, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Universitätsstraße 19, D-91054 Erlangen, Germany.

Annals of Anatomy = Anatomischer Anzeiger : Official Organ of the Anatomische Gesellschaft
|April 2, 2021
PubMed

Insights

Understanding variations in the femoral artery (FA) and deep femoral artery (DFA) branching is crucial for procedures like TAVR. This study classifies DFA origins and notes nerve branching patterns near the lateral circumflex femoral artery (LCFA).

Area of Science:

  • Anatomy
  • Vascular Surgery
  • Radiology

Background:

  • Knowledge of arterial variations in the femoral artery (FA), deep femoral artery (DFA), and circumflex femoral arteries (LCFA, MCFA) is critical for diagnostic angiographic procedures.
  • Anatomical variations can significantly impact the success and safety of endovascular interventions and surgical procedures.

Purpose of the Study:

  • To investigate the frequency and patterns of branching for the FA, DFA, LCFA, and MCFA.
  • To analyze gender and side differences in these arterial variations.
  • To establish a classification for the origin of the DFA relative to the inguinal ligament (IL).

Main Methods:

  • Anatomical variations were studied in 111 thighs from body donors.
  • The frequency of branching patterns of the FA, DFA, LCFA, and MCFA was documented.
  • Statistical analysis was performed to identify gender and side-specific differences.

Main Results:

  • The median separation distance of the DFA from the FA relative to the IL was 3.29 cm.
  • High and middle origins of the DFA were equally distributed (39.3% and 41.1%), while low origins were rare (19.6%) and tended to occur in males.
  • The LCFA and MCFA most commonly originated from the DFA (70.2% and 74.7%, respectively), with trifurcation of the FA being infrequent (9.9%).
  • Femoral nerve (FN) branches typically passed anterior or anterior and posterior to the LCFA (46.4% and 47.8%), with posterior-only passage being rare and tending towards the left side.

Conclusions:

  • This study provides the first classification of DFA origin relative to the IL into three groups.
  • Understanding DFA branching is essential for cardiac procedures using femoral access (e.g., TAVR, VAD, ECMO).
  • Awareness of variant femoral nerve topography relative to the LCFA is important for anterolateral thigh flap harvesting.
Abstract

Keywords:
Arterial variationBranching patternFemoral arteriesFemoral nerveThigh

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