Study of variations in profunda femoris artery and its circumflex femoral branches in thiel embalmed cadavers

Introduction: Studying the possible variations of the profunda femoris artery and its circumflex femoral brancheswill guide surgeons and other health professionals during surgical and radiological procedures.Methods: The study investigated variations in the vascular patterns of origin of the profunda femoris artery, themedial circumflex femoral and the lateral circumflex femoral artery in 20 (7 males and 13 females) Thielembalmed cadavers of the Centre for Anatomy and Human Identification (CAHID), University of Dundee, DundeeUnited Kingdom. Distances were measured between the origin of the PFA and midpoint of the inguinal ligament,between the origins of the MCFA and PFA and from the origin of LCFA to the origin of PFA. The data were analysedwith IBM SPSS.Results: The PFA originated mostly from posterolateral aspect of the FA and the PFA was found to also originatefrom anteromedial side of the FA. The medial and lateral circumflex femoral arteries originated from the PFA withincidences of 47.5% and 87.5% respectively, both originated separately as a common origin with PFA and fromthe femoral artery.Conclusion: Variation research can potentially reduce complications that may arise from ignorance of theramifications in the vascular patterns. An awareness of PFA variations will help to carry out radiologicalinterventions, to define vascular patterns, helps during orthopaedic procedures in the femoral region such aship replacement and is also a basic requirement during femoral artery puncture to minimise cases of severesecondary bleeding

Variations In The Origin Of Medial Circumflex Femoral Artery

Medial circumflex femoral artery(MCFA) usually arises from the Profunda femoris artery(PFA) in the femoral triangle and is the chief source of blood supply to the head of femur. Knowledge about the anatomy of MCFA is essential during orthopedic procedures and interventional surgeries. AIM: To study the variations in the origin of medial circumflex femoral artery MATERIALS AND METHODS:100 lower limbs, by dissection method. RESULTS: MCFA arose from PFA in 65% and from FA(Femoral artery) in 35%.A common stem for PFA and MCFA was found in 15%.A common stem for MCFA, Lateral circumflex femoral artery and PFA was found in 4%.

Variation In Branching Pattern Of Femoral Artery

Background: During clinical procedure to prevent damage, anatomical knowledge of the common femoral artery,profunda femoris artery (PFA) and the circumflex arteries is essential.Material and Methods: Present study was done on 40 lower limbs (20 left and 20 right) in Government MedicalCollege and Hospital, Chandigarh. Dissection was done as per the guidelines in Chunighums.Aim: Present study was done to discuss variations in branching pattern of FA, PFA and also their embryologicaland clinical significances.Results: In the present study, we observed that length of FA (Femoral artery) commonly placed “between” 310-350mm in 55% (22 cases in which 14 right & 8 cases on left side) whereas outer circumferential diameter iscommonly placed “between” 16 -20 mm in 52.5% (21 cases) 10 right & 11 left lower limbs and detailed finding arediscussed with literature.Conclusions: This study will be very helpful to the surgeons, radiologist and plastic surgeons to understandpossible variations and also will be very useful in reducing the chances of intra-operative secondary haemorrhageand post-operative complications.

Morphological Study Of Profunda Femoris Artery: A Cadaveric Study

Introduction: The anatomical knowledge of variations of femoral artery and its branches is important as it isfrequently accessed by surgeons and radiologists for number of procedures. Profunda femoris artery is thelargest branch of femoral artery, it is chief supply of the thigh. It is frequently incorporated in vascularreconstructive procedures in the proximal leg. Femoral artery is frequently accessed by radiologists for numberof procedures, and surgeons. Accurate knowledge of anatomical variations of femoral artery and its branchesincluding profunda femoris, medial and lateral femoral circumflex arteries is required to minimize complicationsand hence it is suggested for the clinicians planning surgery and intervention.Materials and Methods: In the present study, dissection was performed on 70 lower extremities of 35 embalmedcadavers in the department of Anatomy, Yenepoya Medical College Mangalore. The distance of the site of originof profunda femoris artery from the midpoint of the inguinal ligament was measured in mm with a scale andrecorded. The site of origin of medial and lateral circumflex femoral arteries were studied.Results: In present study of profunda femoris artery, we found posterolateral and lateral aspect of origin wascommon (72.85%) than posterior and posteromedial aspect of origin (19.83%). In three limbs (3.03%) profundafemoris artery was originating from medial side of femoral artery and it coursed superficial to femoral vein. Asper various literatures this is rare. The site of origin of profunda femoris artery was between 21-40 mm on 48limbs. In 12 limbs we found high origin of profunda femoris artery (distance < 10mm). In 10% cases profundafemoris artery took origin as a common stem of femoral artery, that is origin of profunda femoris and twocircumflex arteries from single site.Conclusion: Anatomical knowledge of branching pattern of femoral and profunda femoral artery and their distanceof origin is very important to surgeons to avoid inadvertent damage to these vessels and to avoid complicationsduring surgeries. the complications in vascular reconstructive surgeries.

A rare double profunda femoris artery in a female cadaver / 대한해부학회지

The profunda femoris artery (PFA) represents the first and largest branch of the femoral artery in the thigh. A series of anatomical variations are reported, mostly concerning its point of origin and its altered trajectories within the lower limb. We present a rare case of a double PFA, where each separate branch followed the expected arterial pattern. Our case aim to alert surgeons and radiologists for the possibility to encounter an unexpected vascular alternation. Knowledge of topographical anatomy of the PFA and its variations is essential for possible complications after interventional procedures to be avoided.

A Cadaveric Study of Variatons in the Origin of Lateral Circumflex Femoral Artery.

Introduction: The lateral circumflex femoral artery is a branch of the profunda femoris artery, which is the largest branch of femoral artery. The knowledge of origin and branching patterns of the lateral circumflex femoral artery is valuable for various surgeries and clinical procedures. Objectives: To determine mode of origin of lateral circumflex femoral artery and to determine the distance of origin of lateral circumflex femoral artery from the origin of profunda femoris artery and from mid-inguinal point. Materials and Method: 130 femoral triangles were studied and various measurements were noted and analysed from the department of anatomy of various Medical colleges of Gujarat. Result and conclusion: The lateral circumflex femoral artery originated from profunda femoris artery in 119 cases and from femoral artery in 11 cases. In most of the cases, the distance of origin of lateral circumflex femoral artery from the origin of profunda femoris artery was ranging from 11 to 40 mm on both the sides.

A Study on the Patterns of Circumflex Femoral Arteries.

Context: Many different patterns have been described to classify the origins of circumflex femoral arteries by many authors since from 1860.The aim of the present study was to classify the circumflex femoral arteries in 100 lower limbs of adult cadavers of both sexes following the recent classification and to compare with the previous studies. Materials and Methods: A total of 100 lower limbs of 50 embalmed human adult cadavers (Male: 37, Female: 13) were dissected and observed for the origins of circumflex femoral arteries in femoral triangle in routine educational dissection in the period of 2005-2009 Results: The medial and lateral circumflex femoral arteries have been classified into three different patterns based on the levels of their origin. Pattern I: Both arteries arose from the profunda femoris artery (56%). Type Ia, medial circumflex femoral artery origin was proximal to the lateral circumflex femoral artery origin (69%); Type Ib, lateral circumflex femoral artery origin was proximal to medial circumflex femoral artery origin (16 %); Type Ic, both arteries arose from a common trunk or at same level (14%). Pattern II: One of the arteries arose from the femoral artery and the other from the profunda femoris artery (36%). Type IIa, the medial circumflex femoral artery arose from the femoral artery (75%) and Type IIb, the lateral circumflex femoral artery arose from the femoral artery (25%).Pattern III: Both arteries arose from the femoral artery (7%). The medial circumflex femoral artery was absent in a female cadaver on right side. Conclusion: In every pattern or type, there was significantly unilateral higher occurrence than bilateral occurrence. A precise knowledge of the circumflex femoral arteries in relation to the profunda femoris artery is important in surgical interventions of the hip region.

Cadaveric study: study of lateral circumflex femoral arterial origin in Rajkot.

Background: Lateral circumflex femoral artery contributes cruciate, trochanteric and knee joint anastomosis. In addition Lateral circumflex femoral artery flaps are used for the reconstruction of large tissue loss in the head and neck region, aortopopliteal bypass, coronary artery bypass grafting and extracranial intracranial bypass surgery. This work was carried out (a) to study the origin of lateral circumflex femoral artery and (b) to measure and compare (between male and female) the circumference at its origin. Methods: In this cross sectional study, 51 femoral triangles from 26 (18 male and 08 female) human adult cadavers were dissected and studied at P.D.U. government medical college, Rajkot, Gujarat. Site of origin of lateral circumflex femoral artery was identified and noted. The distance of origin of the artery from the origin of profunda femoris artery was measured and noted. Circumference at the level of origin was measured and diameter was calculated. Collected data was analysed by standard statistical formulas with the help of Microsoft excel 2013 and Epi info 7TM software. Results: 90.19% lateral circumflex femoral arteries originated from the profunda femoris artery and remaining 9.81% from the femoral artery. The mean distance of origin of the artery from the origin of profunda femoris artery was 18.44 mm. Lateral circumflex femoral artery circumference and diameter were significantly different between male and female (95% confidence interval, P <0.05). Conclusion: In this presented study maximum distance of origin of the artery from the origin was 65 mm while minimum distance of origin was 6 mm. In addition difference in circumference of the artery was statistically significant.

Study of Profunda Femoris Artery of Human Cadavers in Rajkot City, India.

Background: The profunda femoris artery is the major branch of the femoral artery. It is at critical place in relation to femoral artery for various interventions. Aim: To study the origin of profunda femoris artery. And to compare the cross sectional area of profunda femoris artery between right and left limbs. Material and methods: In this cross sectional study, 51 human femoral triangles from 26 (18 male and 08 female) human cadavers in P.D.U. Government Medical College, Rajkot were dissected and studied during regular dissection classes. Site of origin of profunda femoris artery was noted in relation to femoral artery. The distance of origin of profunda femoris artery from the midpoint of inguinal point was measured and noted. Circumference of profunda femoris artery at the level of origin was measured. The cross sectional area was calculated. Collected data was analyzed by standard statistical formulas with the help of Microsoft excel 2007 and Epi info TM 7 software. Result: Most common (52.95% cases) site of origin was posterolateral from femoral artery. The mean distance of origin of profunda femoris artery from the midpoint of inguinal ligament was 30.17 mm. There was no significant difference in cross sectional area of right and left profunda femoris artery (at 95% confidence interval) Conclusion: Profunda femoris artery is used for angiography, ultrasonography and cardiac catheterization also. It is the major blood supply of the thigh. Its relations with femoral artery, femoral vein and femoral nerve makes it important structure for clinicians. Variations in origin of profunda femoris artery must be considered to avoid complication like aneurism and faulty passage of the catheter. High origin of profunda femoris artery is more prone to damage while accessing femoral artery.

Study of Medial Circumflex Femoral Artery and Its Clinical and Surgical Importance.

Background: The diagnosis and treatment of idiopathic ischemic necrosis of head of femur needs the anatomy of medial circumflex femoral artery (MCFA) which is the main source for the blood supply of head of femur. As it gives the muscular perforators its knowledge is important in the posteromedial cutaneous flap (gracilis flap). In the femoral artery obstruction, MCFA takes bypass route for the blood supply of lower limb as it forms anastomosis with branches of other arteries. Objectives: The study describes the origin and course of the medial circumflex artery. Methods: The present study was conducted on 50 lower limbs from embalmed human cadavers from the Department of Anatomy, Bangalore Medical College and Research Institute, Bengaluru. Femoral triangle was dissected and the medial circumflex artery and branches were traced. Results: The study describes that in 8-10% cases MCFA showed variations whereas in 90-92% cases the MCFA has taken normal origin and course.

Morphological Study of Medial Circumflex Femoral Artery In Human Cadavers.

Background: Medial circumflex femoral artery is an important branch of Profunda femoris artery. It is an important artery in supplying blood to the head and neck of the femur, the adductor muscles and form anastomosis around head of femur. So study of variation of medial circumflex femoral artery great value for surgeon and orthopaedic surgeries. Materials and Methods: The present study includes 102 lower limbs of adult formalin fixed human cadavers used for the routine dissection procedure for under graduate and post graduate students in the department of Anatomy, M.R. Medical College, KBN Medical college and H K E Homeopathic College, Gulbarga (India) during 2011-2014.The study was done by dissection method as per Cunningham’s manual of practical Anatomy. Result: In present study, we found that 25 extremities (25.49%) medial circumflex femoral artery was originated directly from femoral artery. In 10 extremities (9.80%) a common trunk was observed form medial circumflex femoral with femoral artery. Normal study was observed in 66 extremities (64.70%). Conclusion: In present study and other past studies we conclude that knowledge of variation in this artery is very important to preventing injury to vessels during surgical procedures around hip joint and also has important value in plastic surgery operations as the vascular pedicle of grafts such as the transverse upper gracilis (TUG) flap, medial thigh flap and medial circumflex femoral (gracilis) perforator free flap. During case of selective arteriography in ischaemic necrosis of the femoral head to know the arterial supply of the femoral head it is used.

Study of Lateral Circumflex Femoral Artery.

Background: Lateral circumflex femoral artery is a one of most important branch of Profunda femoris artery. It is an artery supplying blood to the head and neck of the femur and form anastomosis around upper part of femur. In many cases artery is useful for bypass surgery like aortopopliteal bypass, anterolateral thigh flap, coronary bypass surgery. Hence the knowledge of variations of artery and its branches are useful during operations such as total hip arthroplasty and other surgery to prevent haemorrhage and other complications. Methods: The present study includes 102 lower limbs of adult formalin fixed human cadavers used for the routine dissection procedure for under graduate and post graduate students in the department of Anatomy, M.R. Medical College, KBN Medical college and H K E Homeopathic College, Gulbarga during 2011-2014.The study was done by dissection method as per Cunningham’s manual of practical Anatomy. Results: The origin of lateral circumflex femoral artery from profunda femoral artery on lateral aspect was observed in 82 limbs (80.38%).Origin of lateral circumflex femoral artery from femoral artery having common stem with Profunda femoris artery were observed in 11 limbs (10.78%).Origin of lateral circumflex femoral artery from femoral artery were observed in 7 limbs (7.8%). Conclusion: Concluding and comparison of our study and past studies, all knowledge of the normal anatomy and variations of the site of origin and course of the LCF artery is not only surgical importance during vascular diagnostic intervention and surgeries but also helps in reducing the chances of intra-operative secondary haemorrhage and post-operative complications.

Analysis of the Height of Origin of Profunda Femoris Artery from the Femoral Artery with regards to the Inguinal Ligament.

Background and aims: To determine the place of height of origin of profunda femoris artery from the femoral artery with regards to the inguinal ligament. Materials and methods: Routine dissection of 6 formalin fixed cadavers (3 males and 3 females) on both lower limbs (totally 12 lower limbs) allotted for the first year students of Kanyakumari Government Medical College, Aasaripallam, Nagercoil. Result: Among them an unusual origin of profunda femoris artery was observed on the left lower limb in a 60 years old female cadaver (8.33%). The profunda femoris artery arose laterally about 0.5 cms from the femoral artery distal to the inguinal ligament. It arose normally on the right lower limb(3.5 cms from the inguinal ligament). Conclusion: A variance in height of origin of profunda femoris artery and its branches will cause changing in the calibers strongly influencing vascularisation quality of belonging flaps. In occlusion of the superficial femoral artery, the profunda femoris artery forms an effective collateral bed between iliofemoral segment and the popliteal artery and its branches. Percutaneous femoral artery cannulation can cause pseudo aneurysms. When this occurs the puncture site is frequently in the profunda femoris artery, where anatomic relationships make hemostasis difficult to achieve. These complications landed up in the study of relations of these arterial complications in the palpable landmarks.

Unusual branching pattern of external iliac artery: case report / Patrón inusual de ramificación de la arteria ilíaca externa: reporte de caso

During the routine dissection, a rare anomaly was observed in left lower limb of a female cadaver. The external iliac artery continued as femoral artery, branched on lateral side as the lateral circumflex femoral artery and on medial side as profunda femoris artery. On tracing the lateral circumflex femoral artery, the ascending branch towards the spinous anastomosis was very thin and coursed behind the rectus femoris muscle. The transverse and descending branches were not observed, however, the artery coursed along the vastus lateralis towards the knee. The femoral artery had its normal course and continued as popliteal artery. The profunda femoris artery originated from the medial side of the external iliac artery, initially superficial to the femoral vein, coursed downwards and posteriorly, relating posteromedial to femoral artery. The medial circumflex femoral artery originated as thin branch, which further divided into two divisions. The profunda femoris gave origin of 3 perforators and continued as 4th perforator. The unusual branching pattern was observed to be novel and not reported in the literature.

Durante una disección de rutina, se observó una rara anomalía en el miembro inferior izquierdo de un cadáver de sexo femenino. La arteria ilíaca externa dio origen en el lado lateral ala arteria circunfleja femoral lateral y en el lado medial a la arteria femoral profunda. En el recorrido de la arteria circunfleja femoral lateral, la rama ascendente era muy delgada y corría detrás del músculo recto femoral. No se observaron ramas transversales y descendente, sin embargo, la arteria descendió hacia la rodilla a lo largo del músculo vasto lateral. La arteria femoral tuvo su curso normal y continuó como arteria poplítea. La arteria femoral profunda, inicialmente superficial a la vena femoral, se dirigió inferior y posteriormente colocándose posteromedial a la arteria femoral. La arteria circunfleja femoral medial se originó como una rama delgada, que otorgó dos arterias. La arteria femoral profunda dio origen a tres ramas perforantes y continuó como cuarta perforante. Este patrón de ramificación inusual es una descripción nueva no reportada en la literatura.

The applied anatomic study on lateral thigh perforator flap / 中华显微外科杂志

Objective To provide anatomic evidence for the application of the lateral thigh perforator flap.Methods Dissected five fresh Chinese adult lower limbs specimens which were injected with red latex via arterial cannula.On the lateral area of middle and distal thigh,obseved the number,distribution,course,category,length of pedicle and external diameter of the flaps' perforators on specimens.Results On the lateral area of middle and distal thigh 19 perforator arteris were observed in these specimens,averagely there were (3.8 ± 1.3) cutaneous perforators in each flap.Perforators mainly origined from the third perforator artery of profunda femoris,secondly from the second,fourth perforator artery and superior lateral genicular artery.Cutaneous perforators of the third perforator artery of profunda femoris pierced the flap on (13.8 ± 1.5) cm proximal of the fibulae capitulum,while the cutaneous perforators of superior lateral genicular artery on (8.6 ± 1.3) cm proximal of the fibulae capitulum.Averagely internal diameter of cutaneous perforators was (0.7 ± 0.2) mm at the point where the perforators pierced deep fascia.The diameter of the profunda femoris was (1.9 ± 0.2) mm,and the pedicle length was (12.2 ± 0.6)cm.The diameter of superior lateral genicular artery was (1.5 ± 0.2)mm,and the pedicle length was (6.8 ± 1.1) cm.There were inosculated branch in these perforators which came from profunda femoris and superior lateral genicular artery.Conclusion The anatomic characteristic allowed this flap would likely be clinically useful in repairing soft tissue defects in extremity limbs as a free or pedicled flap,which the cutaneous perforators invariably appeared on the skin of lateral areat of middle and distal thigh ; the flap could obtain enough length of the pedicle from its origination ; the vessel has large caliber supporting a substantial cutaneous territory.

Absence of the arteria profunda femoris / Ausencia de la arteria femoral profunda

At arteria femoralis, arteria profunda femoris is the main branch feeding the thigh. After iliofemoral embryological evolution many variations can be seen in this vessel. The absence of a. profunda femoris is one of the rare seen variation among these variations. Knowing the anatomy and variations of a. profunda femoris well, is important in low extremity ischemia, vessel surgery and angiography applications. In this study, 1036 films belonging to low extremity found in the Radiology department of School of Medicine of Cumhuriyet University were examined as retrospective. Among these films at four of them of male cases, absence of a. profunda femoris was detected. In cases at ages of 32, 37, 47 and 53 respectively, in the first and second case at the right low extremity there was no a. profunda femoris and at the left low extremity it was seen that a. circumflexus femoris medialis and a. circumflexus femoris lateralis emerged from a. profunda femoris. In the third case it was detected that at left low extremity a. profunda femoris did not exist, and at right low extremity a. circumflexus femoris lateralis emerged from a. profunda femoris, and a. circumflexus femoris medialis emerged from a. femoralis. In the fourth case at left low extremity there was no a. profunda femoris and at right low extremity it was seen that at a. profunda femoris and a. femoralis were in unsteady course. The absence of a. profunda femoris had 0,4 percent. The results were discussed by comparing with literature data.

La arteria femoral profunda, se origina de la arteria femoral, siendo la rama principal que alimenta al muslo. Después de la evolución embriológica de las aa. iliofemorales, muchas variaciones pueden verse en este vaso. La ausencia de una a. femoral profunda es una rara variación observada dentro de estas variaciones. Conocer la anatomía y las variaciones de la a. femoral profunda, es importante para la isquemia de los miembros inferiores, cirugía vascular y aplicaciones en angiografía. En este estudio, fueron examinadas retrospectivamente 1036 placas imagenológicas del miembro inferior, pertenecientes al departamento de Radiología de la Facultad de Medicina de la Cumhuriyet University. Entre estas placas, en cuatro casos pertenecientes a hombres, se detectó la ausencia de la a. femoral profunda. Los casos comprendieron a individuos cuyas edades eran 32, 37, 47 y 53 años, respectivamente. En el primer y segundo caso en el miembro inferior derecho no había una a. femoral profunda y en el miembro inferior izquierdo, se vio que la aa. circunflejas femorales medial y lateral se originaban de la a. femoral profunda. En el tercer caso se observó ausencia de la a. femoral profunda en el miembro inferior izquierdo, y en el miembro inferior derecho, la a. circunfleja femorale lateral se originaba desde la a. femoral profunda, y la a. circunfleja femoral medial se originaba desde la a. femoral. En el cuarto caso en el miembro inferior izquierdo, no existía la a. femoral profunda y en el miembro inferior derecho se observó que tanto la a. femoral como la a. femoral profunda tenían un curso variable. La ausencia de la a. femoral profunda fue del 0,4 por ciento. Los resultados fueron analizados y comparados con la literatura.

The origin of profunda femoris artery in Thais.

This study was to investigate the variation patterns of the origin of profunda femoris artery (PFA) in terms of normal and variation patterns in human preserved cadavers. Two hundred and twenty four femoral triangles in human preserved cadavers were dissected. Sites of origins were identified. Diameter and distance of PFA were measured. We found that PFA was mostly originated from posterior site of femoral artery (FA) at a distance of 35 mm from midpoint of inguinal ligament. Compared between sexes and sides, these distances in females (31.54 mm) approved more proximally than those of males (37.68 mm) at p=0.017. Moreover, the distances on the left sides (33 mm) approved more proximally than the right sides (36.22 mm) at p=0.006. The average diameters of PFA were 5 mm, females (5 mm) were smaller than males (5.42 mm) with p=0.017. In conclusion, PFA that we found was originated from posterior site of FA and average distance of its origin was about 35 mm. Regarding undertaking operative or interventional procedures within the femoral region, this knowledge could be applied to prevent complication during surgical approach or percutaneous vascular access.

Treatment of reoperation on blood vessel prosthesis occlusion after arterial bypass graft in lower limbs / 中国医师进修杂志

Objective To review reoperation on blood vessel prosthesis occlusion after arterial bypass graft in lower limbs. Method The treatment effect of 21 patients with reoperation on blood vessel prothesis occlusion after arterial bypass graft in lower limbs was analyzed retrospectively. Results All the cases were followed up 6-36 (12 ±3) months. The limb salvage rate was 71.4%(15/21) ,the amputation rate was 28.6% (6/21). All 9 limbs that underwent revascularization from deep femoral artery reserved. Conclusions Endomembrane hyperplasy, occlusion of the inflow and outflow tracts are the major reasons for the occlusion of blood vessel prosthesis after arterial bypass graft in lower limbs. Appropriate procedures should be based on careful consideration of the occlusion reasons. Profundaplasty is an effective therapy for those who are treated by reoperation on blood vessel prosthesis occlusion in lower limbs.

Variational anatomy of the profunda femoris artery in Thais.

The profunda femoris artery is the great vessel in the thigh. To study the origin and branching variations of this artery, 113 legs were dissected and then the anatomical patterns were classified. The profunda femoris artery originated at an average distance of 4.28 cm. below the inquinal ligament. The most common origin was postero-lateral, occurring in 37.2% of the specimens. The most common origin of the lateral circumflex femoral artery was of the branch from the profunda femoris artery similar to the medial circumflex femoral artery occurring in 77.0% of the specimens. The average number of perforating arteries was three, including the end of the profunda femoris artery.