The femoral artery is a large

artery An artery (plural arteries) () is a blood vessel in humans and most animals that takes blood away from the heart to one or more parts of the body (tissues, lungs, brain etc.). Most arteries carry oxygenated blood; the two exceptions are the pu ...

in the

thigh In human anatomy, the thigh is the area between the hip ( pelvis) and the knee. Anatomically, it is part of the lower limb. The single bone in the thigh is called the femur. This bone is very thick and strong (due to the high proportion of ...

and the main arterial supply to the thigh and leg. The femoral artery gives off the deep femoral artery or profunda femoris artery and descends along the anteromedial part of the thigh in the femoral triangle. It enters and passes through the adductor canal, and becomes the popliteal artery as it passes through the adductor hiatus in the adductor magnus near the junction of the middle and distal thirds of the thigh.

Structure

The femoral artery enters the thigh from behind the

inguinal ligament The inguinal ligament (), also known as Poupart's ligament or groin ligament, is a band running from the pubic tubercle to the anterior superior iliac spine. It forms the base of the inguinal canal through which an indirect inguinal hernia may ...

as the continuation of the external iliac artery. Here, it lies midway between the

anterior superior iliac spine The anterior superior iliac spine ( abbreviated: ASIS) is a bony projection of the iliac bone, and an important landmark of surface anatomy. It refers to the anterior extremity of the iliac crest of the pelvis. It provides attachment for the i ...

and the

symphysis pubis The pubic symphysis is a secondary cartilaginous joint between the left and right superior rami of the pubis of the hip bones. It is in front of and below the urinary bladder. In males, the suspensory ligament of the penis attaches to the pubic ...

(Mid-inguinal point).

Segments

Common femoral and subsartorial artery and vein

In clinical parlance, the femoral artery has the following segments: *The common femoral artery (CFA) is the segment of the femoral artery between the inferior margin of the

and the branching point of the deep femoral artery/profunda femoris artery. Its first three or four centimetres are enclosed, with the

femoral vein In the human body, the femoral vein is a blood vessel that accompanies the femoral artery in the femoral sheath. It begins at the adductor hiatus (an opening in the adductor magnus muscle) as the continuation of the popliteal vein. It ends a ...

, in the femoral sheath. In 65% of people, the common femoral artery lies anterior to the femoral vein in the upper thigh. *The subsartorial artery or superficial femoral artery are designations for the segment between the branching point of the deep femoral artery and the adductor hiatus, passing through the subsartorial canal. However, usage of the term ''superficial femoral'' is discouraged by many

physician A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...

s because it leads to confusion among general medical practitioners, at least for the

that courses next to the femoral artery. In particular, the adjacent femoral vein is clinically a

deep vein A deep vein is a vein that is deep in the body. This contrasts with superficial veins that are close to the body's surface. Deep veins are almost always beside an artery with the same name (e.g. the femoral vein is beside the femoral artery). ...

, where deep vein thrombosis indicates

anticoagulant Anticoagulants, commonly known as blood thinners, are chemical substances that prevent or reduce coagulation of blood, prolonging the clotting time. Some of them occur naturally in blood-eating animals such as leeches and mosquitoes, where t ...

or thrombolytic therapy, but the adjective ''"superficial"'' leads many physicians to falsely believe it is a

superficial vein Superficial veins are veins that are close to the surface of the body, as opposed to deep veins, which are far from the surface. Superficial veins are not paired with an artery, unlike the deep veins, which are typically associated with an art ...

, which has resulted in patients with femoral thrombosis being denied proper treatment. Therefore, the terms ''subsartorial artery'' and ''subsartorial vein'' are sometimes used for the femoral artery and vein, respectively, distally to the branching points of the deep femoral artery and vein. The subaortorial artery passes through the adductor hiatus to enter popliteal fossa and continue as popliteal artery.

Relations

The ''relations'' of the femoral artery are as follows: * ''Anteriorly:'' In the upper part of its course, it is superficial and is covered by skin and fascia. In the lower part of its course, it passes behind the

sartorius muscle The sartorius muscle () is the longest muscle in the human body. It is a long, thin, superficial muscle that runs down the length of the thigh in the anterior compartment. Structure The sartorius muscle originates from the anterior superior ili ...

. * ''Posteriorly:'' The artery lies on the psoas, which separates it from the hip joint, the

pectineus The pectineus muscle (, from the Latin word ''pecten'', meaning comb) is a flat, quadrangular muscle, situated at the anterior (front) part of the upper and medial (inner) aspect of the thigh. The pectineus muscle is the most anterior adductor ...

, and the adductor longus. The femoral vein intervenes between the artery and the adductor longus. * ''Medially:'' It is related to the femoral vein in the upper part of its course. * ''Laterally:'' The femoral nerve and its branches.

Branches

Common femoral artery

* The

superficial circumflex iliac artery The superficial iliac circumflex artery (or superficial circumflex iliac), the smallest of the cutaneous branches of the femoral artery, arises close to the superficial epigastric artery, and, piercing the fascia lata, runs lateralward, parallel w ...

is a small branch that runs up to the region of the

. * The

superficial epigastric artery The superficial epigastric artery (not to be confused with the superior epigastric artery) arises from the front of the femoral artery about 1 cm below the inguinal ligament, and, passing through the femoral sheath and the fascia cribrosa, ...

is a small branch that crosses the inguinal ligament and runs to the region of the umbilicus. * The superficial external pudendal artery is a small branch that runs medially to supply the skin of the scrotum or labium majus as. * The deep external pudendal artery runs medially and supplies the skin of the scrotum or labium majus. * The profunda femoris artery is a large and important branch that arises from the lateral side of the femoral artery about 1.5 in. (4 cm) below the inguinal ligament. It passes medially behind the femoral vessels and enters the medial fascial compartment of the thigh. It ends by becoming the fourth perforating artery. At its origin, it gives off the medial and lateral circumflex femoral arteries, and during its course it gives off three perforating arteries.

Subaortorial artery/superficial femoral artery

* The descending genicular artery is a small branch that arises from the femoral artery near its termination within the adductor canal. It assists in supplying the knee joint.

Clinical significance

Clinical examination

The site for optimally palpating the ''femoral pulse'' is in the inner thigh, at the mid-inguinal point, halfway between the pubic symphysis and anterior superior iliac spine. Presence of a ''femoral pulse'' indicates a systolic

blood pressure Blood pressure (BP) is the pressure of circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term "blood pressure ...

of more than 50 mmHg.

Vascular access

Femoral artery is the frequent site of access in angiography. As the pulsation of the common femoral artery can often be palpated through the skin; and the site of maximum pulsation is used as a point of puncture for catheter access. From here, wires and catheters can be directed anywhere in the arterial system for intervention or diagnostics, including the heart, brain, kidneys, arms and legs. The direction of the needle in the femoral artery can be against blood flow (retro-grade), for intervention and diagnostic towards the heart and opposite leg, or with the flow (ante-grade or ipsi-lateral) for diagnostics and intervention on the same leg. Access in either the left or right femoral artery is possible and depends on the type of intervention or diagnostic. To image the lower limb vascular anatomy, common femoral artery (CFA) is chosen as the site of entry. However, CFA entry can only be assessed by retrograde puncture. Therefore, a catheter is advanced retrogradely through the contralateral common femoral artery into common iliac artery, crossing the midline into ipsilateral CFA. The SFA can then be assessed by antegrade puncture. The femoral artery can be used to draw arterial blood when the blood pressure is so low that the radial or brachial arteries cannot be located.

Peripheral arterial disease

The femoral artery is susceptible to

peripheral arterial disease Peripheral artery disease (PAD) is an abnormal narrowing of arteries other than those that supply the heart or brain. When narrowing occurs in the heart, it is called coronary artery disease, and in the brain, it is called cerebrovascular dise ...

. When it is blocked through atherosclerosis, percutaneous intervention with access from the opposite femoral may be needed.

Endarterectomy Endarterectomy is a surgical procedure to remove the atheromatous ''plaque'' material, or blockage, in the lining of an artery constricted by the buildup of deposits. It is carried out by separating the plaque from the arterial wall. It was first ...

, a surgical cut down and removal of the plaque of the femoral artery is also common. If the femoral artery has to be ligated surgically to treat a popliteal

aneurysm An aneurysm is an outward bulging, likened to a bubble or balloon, caused by a localized, abnormal, weak spot on a blood vessel wall. Aneurysms may be a result of a hereditary condition or an acquired disease. Aneurysms can also be a nidus ( ...

, blood can still reach the popliteal artery distal to the ligation via the genicular anastomosis. However, if flow in the femoral artery of a normal leg is suddenly disrupted, blood flow distally is rarely sufficient. The reason for this is the fact that the genicular anastomosis is only present in a minority of individuals and is always undeveloped when disease in the femoral artery is absent.

References

Additional images

Gray546.png, Structures passing behind the

. (Femoral artery labeled at upper right.) File:Gray344.png, Cross-section showing structures surrounding right hip-joint. File:Gray545.png, Femoral sheath laid open to show its three compartments. File:Gray550.png, The femoral artery. File:Gray1146.png, The spermatic cord in the inguinal canal. File:Gray1245.png, Front of right thigh, showing surface markings for bones, femoral artery and femoral nerve. File:Gray548.png, Femoral artery and its major branches - right thigh, anterior view. File:Blausen 0607 LegArteries.png, Illustration depicting main leg arteries (anterior view). File:Slide2888.JPG, Femoral artery - deep dissection. File:Slide4888.JPG, Femoral artery - deep dissection.

External links

* *
Image at umich.edu - pulse

QuantaFlo vs ABI in Peripheral Arterial Disease
{{DEFAULTSORT:Femoral Artery Arteries of the lower limb