Anatomic Variations of the Deep Femoral Artery and Its Branches: Clinical Implications on Anterolateral Thigh Harvesting.

Georgia Tzouma,Nikolaos A Kopanakis,George Tsakotos,Dimitrios Filippou,Panagiotis N Skandalakis

doi:10.7759/cureus.7867

Georgia Tzouma, Nikolaos A Kopanakis + Show 3 more

Open Access

https://doi.org/10.7759/cureus.7867

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Abstract

The deep femoral artery (DFA) is the largest branch of the common femoral artery (CFA), supplying with its branches, the medial circumflex femoral artery (MCFA) and lateral circumflex femoral artery (LCFA), the thigh muscles, the hip joint, and the femur. Their anatomical variations have a great impact on both interventional and surgical procedures. The anterolateral thigh (ALT) flap, a versatile soft tissue with highly increasing use in reconstructive surgery, is noticeably influenced by this variability. A total of 25 articles were incorporated into the review. Studies conducted after the year 2009 were included. After the assessment of all studies included, we concluded that the DFΑ arises from the CFA with a varying site of origin, the posterolateral being the prevalent one found in 51.32% of cases. Of all cases studied, the MCFA and the LCFA most often originated from the DFA in 63.125% and 74.92%, respectively, but the CFA constitutes another frequent source of origin in 27% and 12.12% of cases, respectively. The descending branch of the lateral circumflex femoral artery (dLCFA) is the prominent pedicle in the ALT flap, originating from the LCFA in 83.55% of cases. However, the presence of an oblique lateral circumflex femoral artery (oLCFA) branch with changeable origination was observed. Knowledge of the anatomical variants in the deep femoral artery is imperative both for interventional radiologists and surgeons. Especially in reconstructive surgery, the possibility for different sources supplying the skin and the pedicle compel surgeons to acquire an awareness of this subject.

Highlights

BackgroundAnatomic variations of the profunda femoris or deep femoral artery (DFA) constitute a matter of great interest to anatomists, surgeons, and interventional radiologists due to their significant clinical relevance [1]
This study aims to report and illustrate the variable patterns of the origin, course, and ramification of the profunda femoris artery (PFA) and its branches, as well as summarizing the literature data on this
Another cadaveric study conducted on 42 thighs in Serbia by Lalovic et al illustrated that the medial circumflex femoral artery (MCFA) originated from the DFA in 59.5% of cases, at a mean distance of 57.9 ± 19.5 mm from the mid-inguinal point (MIP) [23]

Summary

Introduction

Anatomic variations of the profunda femoris or deep femoral artery (DFA) constitute a matter of great interest to anatomists, surgeons, and interventional radiologists due to their significant clinical relevance [1]. The most frequent site of origin for the LCFA was the lateral site in 75% of the right and 100% of the left limbs Another cadaveric study conducted on 42 thighs in Serbia by Lalovic et al illustrated that the MCFA originated from the DFA in 59.5% of cases, at a mean distance of 57.9 ± 19.5 mm from the MIP [23]. The DFA originated from the medial side of the FA, whereas the LCFA came from the CFA at the same level Another case report regarding an 83-year-old Japanese male cadaver concluded that there was a common trunk of the deep circumflex iliac artery and part of the dLCFA at the transition from the EIA to the CFA under the inguinal ligament (IL) on the right side [30]. The tLCFA, the dLCFA, and, less regularly, the LCFA were recorded as potential origins of this oblique branch

Conclusions

Disclosures

Findings

Sabnis AS