Anat Cell Biol.  2024 Dec;57(4):616-620. 10.5115/acb.24.083.

A variant deep femoral artery passing anterior to femoral vein: an anatomical observation with implication in femoral vein cannulation

• Shoja MM
• De Leon MT
• Sheth J
• Padival S
• Tritsch T
• Schwartz GB

• KMID: 2562511
• DOI: http://doi.org/10.5115/acb.24.083

Abstract

The common femoral artery (CFA) typically gives rise to its superficial and deep branches, with the deep femoral artery (DFA) being the largest and most substantial of these branches. This case study presents a rare variation of the DFA characterized by an unusual branching pattern and its specific relationship with the femoral vein within the subinguinal region. In nutshell, the DFA and the medial femoral circumflex artery shared a common origin from the medial aspect of the CFA. The DFA assumed an unusual course, initially passing anterior to the femoral vein above the saphenofemoral junction, followed by a spiraling trajectory around the medial aspect of the femoral vein before running posteriorly. The embryological origins and clinical implications of this anatomical variation are thoroughly examined. This unusual vascular relationship in the subinguinal region may potentially result in arterial injury during femoral vein cannulation or formation of arteriovenous fistula after the procedure.

Keyword

Angiography; Arteries; Femoral artery; Femoral vein; Vascular system injuries

Figure

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  Fig. 1 Adachi’s special case, illustrating a deep femoral artery (DFA) that crosses over the common femoral vein. The DFA is the medial division of the common femoral artery, shortly below the inguinal ligament. Note the origin of the inferior epigastric, obturator, and medial femoral circumflex arteries from the DFA. Adapted from Adachi ([The arterial system of the Japanese 2]; 1928. p. 111-96), with permission [5].

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  Fig. 2 Anterior view of the left thigh. CFA, common femoral artery; CFV, common femoral vein; M, medial; I, inferior; L, lateral; S, superior.

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  Fig. 3 Medial view of the left thigh. CFA, common femoral artery; CFV, common femoral vein; L, lateral; S, superior; M, medial; I, inferior.

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  Fig. 4 Quain’s depiction of a medial femoral circumflex artery (MFCA) crossing over the common femoral vein. Note the origin of the inferior epigastric and obturator arteries from the convex side of the MFCA. Adapted from Quain and Maclise (The anatomy of the arteries of the human body: and its applications to pathology and operative surgery with a series of lithographic drawings; 1844) [4].

Reference

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