The femoral artery is a large

artery An artery () is a blood vessel in humans and most other animals that takes oxygenated blood away from the heart in the systemic circulation to one or more parts of the body. Exceptions that carry deoxygenated blood are the pulmonary arteries in ...

in the

thigh In 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 bone tissu ...

and the main arterial supply to the thigh and leg. The femoral artery gives off the

deep femoral artery The deep femoral artery also known as the deep artery of the thigh, or profunda femoris artery, is a large branch of the femoral artery. It travels more deeply ("profoundly") than the rest of the femoral artery. It gives rise to the lateral cir ...

and descends along the anteromedial part of the thigh in the

femoral triangle The femoral triangle (or Scarpa's triangle) is an anatomical region of the upper third of the thigh. It is a subfascial space which appears as a triangular depression below the inguinal ligament when the thigh is flexed, abducted and laterally r ...

. It enters and passes through the

adductor canal The adductor canal (also known as the subsartorial canal or Hunter's canal) is an aponeurotic tunnel in the middle third of the thigh giving passage to parts of the femoral artery, vein, and nerve. It extends from the apex of the femoral triang ...

, and becomes the

popliteal artery The popliteal artery is a deeply placed continuation of the femoral artery opening in the distal portion of the adductor magnus muscle. It courses through the popliteal fossa and ends at the lower border of the popliteus muscle, where it branche ...

as it passes through the

adductor hiatus In human anatomy, the adductor hiatus also known as hiatus magnus is a hiatus (gap) between the adductor magnus muscle and the femur that allows the passage of the femoral vessels from the anterior thigh to the posterior thigh and then the poplite ...

in the

adductor magnus The adductor magnus is a large triangular muscle, situated on the medial side of the thigh. It consists of two parts. The portion which arises from the ischiopubic ramus (a small part of the inferior ramus of the pubis, and the inferior ramu ...

near the junction of the middle and distal thirds of the thigh. The femoral artery

proximal Standard anatomical terms of location are used to describe unambiguously the anatomy of humans and other animals. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position prov ...

to the origin of the deep femoral artery is referred to as the ''common femoral artery'', whereas the femoral artery

distal Standard anatomical terms of location are used to describe unambiguously the anatomy of humans and other animals. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position provi ...

to this origin is referred to as the ''superficial femoral artery''.

Structure

The femoral artery represents the continuation of the

external iliac artery The external iliac arteries are two major Artery, arteries which bifurcate off the common iliac arteries anterior to the sacroiliac joint of the pelvis. Structure The external iliac artery arises from the bifurcation of the common iliac arter ...

beyond 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 ...

underneath which the vessel passes to enter the thigh. The vessel passes under the inguinal ligament just medial of the midpoint of this ligament, midway between the

anterior superior iliac spine The anterior superior iliac spine (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 inguinal ligament, ...

and the

symphysis pubis The pubic symphysis (: symphyses) 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 ...

(mid-inguinal point). In common usage, in clinical practice including

angiology Angiology (from Greek , ''angeīon'', "vessel"; and , ''-logia'') is the medical specialty dedicated to studying the circulatory system and of the lymphatic system, i.e., arteries, veins and lymphatic vessels. In the UK, this field is more ...

and

vascular surgery Vascular surgery is a surgical subspecialty in which vascular diseases involving the arteries, veins, or lymphatic vessels, are managed by medical therapy, minimally-invasive catheter procedures and surgical reconstruction. The specialty evolve ...

, the femoral artery includes the common femoral artery, and the superficial femoral artery however, the

Terminologia Anatomica ''Terminologia Anatomica'' (commonly abbreviated TA) is the international standard for human anatomy, human anatomical terminology. It is developed by the Federative International Programme on Anatomical Terminology (FIPAT) a program of the Inter ...

(TA) only lists the femoral artery. (The TA is the international standard for human anatomical terminology developed by the

Federative International Programme on Anatomical Terminology The Federative International Programme for Anatomical Terminology (FIPAT) is a group of experts who review, analyze, and discuss the terms of the morphological structures of the human body. It was created by the International Federation of Assoc ...

). *The common femoral artery (CFA) is located between the inferior margin of the

, and the branching point of the

. Its first three or four centimetres are enclosed, with the

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

, in the

femoral sheath The femoral sheath (also called the crural sheath) is a funnel-shaped downward extension of abdominal fascia within which the femoral artery and femoral vein pass between the abdomen and the thigh. The femoral sheath is subdivided by two vertica ...

. In 65% of people, the common femoral artery lies anterior to the femoral vein in the upper thigh. The CFA is, after the

, the most common peripheral site of general dilatation or aneurysmal formation, at a frequency of 1/10 of the aorta. Highly calcific arterial stenosis in the CFA is very difficult to treat by endovascular intervention. Stent positioning in CFA may be limited by compressive or torsional forces, leading to stent fracture and/or restenosis. On the other hand, lithoplasty balloon angioplasty may represent a safe tool to treat CFA stenosis. *The superficial femoral artery is a designation for the segment between the branching point of the deep femoral artery and the

, passing through the

subsartorial canal The adductor canal (also known as the subsartorial canal or Hunter's canal) is an aponeurotic tunnel in the middle third of the thigh giving passage to parts of the femoral artery, vein, and nerve. It extends from the apex of the femoral tri ...

. However, this term is not listed in ''

'', and usage of the term ''superficial femoral'' is discouraged by many

physician A physician, medical practitioner (British English), medical doctor, or simply doctor is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the Medical education, study, Med ...

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 Deep vein thrombosis (DVT) is a type of venous thrombosis involving the formation of a blood clot in a deep vein, most commonly in the legs or pelvis. A minority of DVTs occur in the arms. Symptoms can include pain, swelling, redness, and enl ...

indicates

anticoagulant An anticoagulant, commonly known as a blood thinner, is a chemical substance that prevents or reduces the coagulation of blood, prolonging the clotting time. Some occur naturally in blood-eating animals, such as leeches and mosquitoes, which ...

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 segment is alternatively termed the subsartorial artery. The segment enters the

and becomes the

which goes through the

popliteal fossa The popliteal fossa (also referred to as hough or kneepit in analogy to the cubital fossa) is a shallow depression located at the back of the knee joint. The bones of the popliteal fossa are the femur and the tibia. Like other flexion surfaces ...

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 ilia ...

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

hip joint In vertebrate anatomy, the hip, or coxaLatin ''coxa'' was used by Celsus in the sense "hip", but by Pliny the Elder in the sense "hip bone" (Diab, p 77) (: ''coxae'') in medical terminology, refers to either an anatomical region or a joint o ...

, 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 o ...

, and the

adductor longus In the human body, the adductor longus is a skeletal muscle located in the thigh. One of the adductor muscles of the hip, its main function is to Adduction, adduct the thigh and it is innervated by the obturator nerve. It forms the medial wall ...

. 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 The femoral nerve is a nerve in the thigh that supplies skin on the upper thigh and inner leg, and the muscles that extend the knee. It is the largest branch of the lumbar plexus. Structure The femoral nerve is the major nerve supplying the ant ...

and its branches.

Branches

Common femoral artery * The superficial circumflex iliac artery is a small branch that runs up to the region of the

. * The superficial epigastric artery 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 The deep external pudendal artery (deep external pudic artery) is one of the pudendal arteries that is more deeply seated than the superficial external pudendal artery, passes medially across the pectineus and the adductor longus muscles; it i ...

runs medially and supplies the skin of the scrotum or labium majus. * The

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 Medial may refer to: Mathematics * Medial magma, a mathematical identity in algebra Geometry * Medial axis, in geometry the set of all points having more than one closest point on an object's boundary * Medial graph, another graph that repr ...

and lateral circumflex femoral arteries, and during its course it gives off three perforating arteries. Superficial femoral artery * The

descending genicular artery The descending genicular artery (also known as the highest genicular artery) arises from the femoral artery just before its passage through the adductor hiatus. The descending geniculate artery immediately divides into two branches: a saphenous br ...

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 The mid-inguinal point (MIP) is located at the middle point of an imaginary line drawn between the anterior superior iliac spine (ASIS) and the pubic symphysis. The mid-inguinal point is superior to (above) the inguinal ligament, and should not to ...

, 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 Circulatory system, 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 ...

of more than 50 mmHg.

Vascular access

Femoral artery is the frequent site of access in

angiography Angiography or arteriography is a medical imaging technique used to visualize the inside, or lumen, of blood vessels and organs of the body, with particular interest in the arteries, veins, and the heart chambers. Modern angiography is perfo ...

. As the pulsation of the common femoral artery can often be

palpated Palpation is the process of using one's hands to check the body, especially while perceiving/diagnosing a disease or illness. Usually performed by a health care practitioner, it is the process of feeling an object in or on the body to determine ...

through the skin; and the site of maximum pulsation is used as a point of puncture for

catheter In medicine, a catheter ( ) is a thin tubing (material), tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. ...

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, the 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 a vascular disorder that causes abnormal narrowing of arteries other than those that supply the heart or brain. PAD can happen in any blood vessel, but it is more common in the legs than the arms. When narr ...

. When it is blocked through

atherosclerosis Atherosclerosis is a pattern of the disease arteriosclerosis, characterized by development of abnormalities called lesions in walls of arteries. This is a chronic inflammatory disease involving many different cell types and is driven by eleva ...

percutaneous {{More citations needed, date=January 2021 In surgery, a percutaneous procedurei.e. Granger et al., 2012 is any medical procedure or method where access to inner organs or other tissue is done via needle-puncture of the skin, rather than by using ...

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 firs ...

, 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 :wikt:bulge, 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 b ...

, blood can still reach the

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:Thigh arteries.svg, 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