Lateral approach to femoral bifurcation

Femoral bifurcation can be approached through a lateral incision in the femoral triangle, passing behind the sartorius muscle and thus leaving undisturbed the femoral lymphatic network. The principal advantage of this route is it limits the local complications that occasionally result in infection of the operative site. This lateral approach is indicated primarily for infrainguinal revascularizations originating from the common femoral artery in patients at high risk for local infection. It should not, however, be used routinely because exposure of the vessels, particularly the medial aspect of the artery and the profundus vessels, is limited. The risks of this route are essentially related to the neural elements encountered during dissection.