The radiographic relationship of the femoral head, inguinal ligament, and common femoral artery bifurcation for...

Area of Science:

• Vascular Surgery
• Anatomy
• Radiology

Background:

• Common femoral artery (CFA) access is crucial for endovascular procedures.
• Access site complications lead to significant morbidity and mortality.

Purpose of the Study:

• To characterize radiographic variability in the relationship between the femoral head, inguinal ligament, and CFA bifurcation.
• To identify an optimal and safe CFA access zone.

Main Methods:

• Human cadaver dissections of the inguinal ligament and CFA bifurcation.
• Radiopaque pins for marking and anteroposterior radiographs.
• Measurements of distances and overlap percentages; heatmap analysis.

Main Results:

• No significant age or sex-related differences in anatomical relationships.
• Significant overlap between the inguinal ligament and femoral head in 82.6% of cases.
• Overlap with the CFA bifurcation occurred in 11.1% of cases.

Conclusions:

• High variability exists in CFA access anatomy, challenging a consistently safe zone.
• The safest access zone, identified by heatmap analysis, is below the midpoint of the femoral head.
• This zone offers >80% likelihood of avoiding critical structures like the inguinal ligament and CFA bifurcation.