Angiographic Anatomy of the Lateral Femoral Circumflex Artery and Preliminary Experience With its Reconstruction During Profundoplasty

Abstract

The lateral femoral circumflex artery (LFCA) and its descending branch (DB) are important collaterals of the profunda femoris artery. The success of a profundoplasty may be enhanced by improving LFCA flow, while inadvertant compromise of the LFCA lumen may adversely affect the results of a profundo plasty. The angiographic anatomy of the LFCA was studied in 200 limbs of patients undergoing aortography for leg ischemia. There were four major anatomic var iations of the LFCA and its DB in respect to their origin from the common and deep femoral arteries. Mean length of the LFCA was 2.5 cm and mean diameter 3.5 mm. Atherosclerotic changes, mainly at the orifice, were seen in 15% of LFCAs. The DB of the LFCA was an important collateral in 102 limbs, in 34 it was the main collateral in the thigh. Its diameter was 3 mm or more in 50% of limbs. These data show the anatomic basis for attempting adjunctive surgical procedures on the LFCA. Preliminary results are reported of 36 profundoplasties during which a spe cific surgical maneuver was directed at the LFCA. Intraoperative blood flow measurements were performed to quantify the LFCA flow capacity and to com pare flow through the LFCA to distal profunda flow. The LFCA and its DB are important collaterals and should be given specific attention in selected cases.