open access

Vol 78, No 4 (2019)
Original article
Submitted: 2018-12-12
Accepted: 2019-01-28
Published online: 2019-03-19
Get Citation

A morphological study of the medial and lateral femoral circumflex arteries: a proposed new classification

P. Łabętowicz1, Ł. Olewnik2, M. Podgórski3, M. Majos4, L. Stefańczyk4, M. Topol5, M. Polguj2
·
Pubmed: 30906974
·
Folia Morphol 2019;78(4):738-745.
Affiliations
  1. Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Lodz, Poland
  2. Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Lodz, Poland
  3. Department of Diagnostic Imaging, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
  4. Department of Radiology, Barlicki University Hospital, Medical University of Lodz, Poland
  5. Department of Angiology, Chair of Anatomy and Histology, Medical University of Lodz, Poland

open access

Vol 78, No 4 (2019)
ORIGINAL ARTICLES
Submitted: 2018-12-12
Accepted: 2019-01-28
Published online: 2019-03-19

Abstract

Background: Confirming the branching pattern of the deep femoral artery (DFA) is vital in planning radiological and surgical procedures involving the medial circumflex femoral artery (MFCA) and the lateral circumflex artery (LFCA). The aim of this study was to characterise the course and morphology of branches of the DFA. Materials and methods: The anatomical dissection included 80 lower limbs which were fixed in 10% formalin solution. A dissection of the femoral region was carried out according to a pre-established protocol, using traditional techniques. Morphometric measurements were obtained twice by two researchers. Results: Six types of medial and lateral femoral circumflex artery variations were distinguished. In type I, the DFA divides into the MFCA and the LFCA (observed in 45% of cases). In type II, the MFCA is absent and the LFCA origin normally from the DFA (18.75%). In type III, the MFCA arises from the femoral artery above the origin of the DFA, while the LFCA starts from the DFA (15%). Finally, in type IV, the LFCA arises from the femoral artery above the origin of the DFA, while the MFCA starts from the DFA (10%). In type V, the LFCA origin alone from the femoral artery below the origin of the DFA, while the MFCA origin from the DFA (7.5%), while in type VI (3.75%), both the MFCA and the LFCA origin from the femoral artery. The mean diameter of the femoral artery at the level of the DFA origin was greatest in type 2 (10.62 ± 2.07 mm) and the least in type 6 (7.90 ± 1.72 mm; p = 0.0317). The distance from inguinal ligament to where the DFA arose was the greatest in type 6 (78.24 ± 29.74 mm) and least in type 5 (28.85 ± 11.72 mm; p = 0.0529). Conclusions: The medial and lateral femoral circumflex arteries were characterised by high morphological variations. The diameter of the femoral artery at the level of inguinal ligament correlated with the diameter of the DFA and distance to where the DFA arises from femoral artery.

Abstract

Background: Confirming the branching pattern of the deep femoral artery (DFA) is vital in planning radiological and surgical procedures involving the medial circumflex femoral artery (MFCA) and the lateral circumflex artery (LFCA). The aim of this study was to characterise the course and morphology of branches of the DFA. Materials and methods: The anatomical dissection included 80 lower limbs which were fixed in 10% formalin solution. A dissection of the femoral region was carried out according to a pre-established protocol, using traditional techniques. Morphometric measurements were obtained twice by two researchers. Results: Six types of medial and lateral femoral circumflex artery variations were distinguished. In type I, the DFA divides into the MFCA and the LFCA (observed in 45% of cases). In type II, the MFCA is absent and the LFCA origin normally from the DFA (18.75%). In type III, the MFCA arises from the femoral artery above the origin of the DFA, while the LFCA starts from the DFA (15%). Finally, in type IV, the LFCA arises from the femoral artery above the origin of the DFA, while the MFCA starts from the DFA (10%). In type V, the LFCA origin alone from the femoral artery below the origin of the DFA, while the MFCA origin from the DFA (7.5%), while in type VI (3.75%), both the MFCA and the LFCA origin from the femoral artery. The mean diameter of the femoral artery at the level of the DFA origin was greatest in type 2 (10.62 ± 2.07 mm) and the least in type 6 (7.90 ± 1.72 mm; p = 0.0317). The distance from inguinal ligament to where the DFA arose was the greatest in type 6 (78.24 ± 29.74 mm) and least in type 5 (28.85 ± 11.72 mm; p = 0.0529). Conclusions: The medial and lateral femoral circumflex arteries were characterised by high morphological variations. The diameter of the femoral artery at the level of inguinal ligament correlated with the diameter of the DFA and distance to where the DFA arises from femoral artery.

Get Citation

Keywords

anatomy, classification, deep femoral artery, lateral circumflex femoral artery, medial circumflex femoral artery, variations

About this article
Title

A morphological study of the medial and lateral femoral circumflex arteries: a proposed new classification

Journal

Folia Morphologica

Issue

Vol 78, No 4 (2019)

Article type

Original article

Pages

738-745

Published online

2019-03-19

Page views

1542

Article views/downloads

1162

DOI

10.5603/FM.a2019.0033

Pubmed

30906974

Bibliographic record

Folia Morphol 2019;78(4):738-745.

Keywords

anatomy
classification
deep femoral artery
lateral circumflex femoral artery
medial circumflex femoral artery
variations

Authors

P. Łabętowicz
Ł. Olewnik
M. Podgórski
M. Majos
L. Stefańczyk
M. Topol
M. Polguj

References (30)
  1. Adachi B. Das Arteriensystem der Japaner. Verlag der Kais Univ zu Kyoto. 1928; 2: 18–71.
  2. Al-Talalwah W. The medial circumflex femoral artery origin variability and its radiological and surgical intervention significance. Springerplus. 2015; 4: 149.
  3. Aslaner R, Pekcevik Y, Sahin H, et al. Variations in the origin of inferior phrenic arteries and their relationship to celiac axis variations on CT angiography. Korean J Radiol. 2017; 18(2): 336–344.
  4. Bergman RA, Afifi AK, Miyauchi R Anatomy Atlases: Illustrated Encyclopedia of Human Anatomic Variation - Anatomical Variation | Radiology Anatomy | Anatomy Atlas. 2015.
  5. Chomiak J, Horák M, Masek M, et al. Computed tomographic angiography in proximal femoral focal deficiency. J Bone Joint Surg Am. 2009; 91(8): 1954–1964.
  6. Fukuda H, Ashida M, Ishii R, et al. Anatomical variants of the lateral femoral circumflex artery: an angiographic study. Surg Radiol Anat. 2005; 27(3): 260–264.
  7. Freitas A, Aires HN, Pansiere ST, et al. Anatomical description of the proximal third of the medial femoral circumflex artery. A cadaveric study. Acta Ortop Bras Brazilian Soc Orthop Traumatol. 2012; 20: 21–24.
  8. Gautier E, Ganz K, Krügel N, et al. Anatomy of the medial femoral circumflex artery and its surgical implications. J Bone Joint Surg Br. 2000; 82(5): 679–683.
  9. Kaempf M, Ketelsen D, Syha R, et al. CT angiography of various superficial femoral artery stents: an in vitro phantom study. Eur J Radiol. 2012; 81(7): 1584–1588.
  10. Lippert H, Pabst R. Arterial variations in man. Classification and frequency. 1985.
  11. Manjappa T, Prasanna LC. Anatomical variations of the profunda femoris artery and its branches: a cadaveric study in South Indian population. Indian J Surg. 2014; 76(4): 288–292.
  12. Massoud TF, Fletcher EW. Anatomical variants of the profunda femoris artery: an angiographic study. Surg Radiol Anat. 1997; 19(2): 99–103.
  13. Mauro MA, Jaques PF, Moore M. The popliteal artery and its branches: embryologic basis of normal and variant anatomy. AJR Am J Roentgenol. 1988; 150(2): 435–437.
  14. Nasr AY, Badawoud MH, Al-Hayani AA, et al. Origin of profunda femoris artery and its circumflex femoral branches: anatomical variations and clinical significance. Folia Morphol. 2014; 73(1): 58–67.
  15. Olasińska-Wiśniewska A, Grygier M, Lesiak M, et al. Femoral artery anatomy-tailored approach in transcatheter aortic valve implantation. Post Kardiol Int. 2017; 13(2): 150–156.
  16. Olewnik Ł, Waśniewska A, Polguj M, et al. Rare combined variations of renal, suprarenal, phrenic and accessory hepatic arteries. Surg Radiol Anat. 2018; 40(7): 743–748.
  17. Olewnik Ł, Wysiadecki G, Polguj M, et al. A rare anastomosis between the common hepatic artery and the superior mesenteric artery: a case report. Surg Radiol Anat. 2017; 39(10): 1175–1179.
  18. Olewnik Ł, Wysiadecki G, Polguj M, et al. Types of coeliac trunk branching including accessory hepatic arteries: a new point of view based on cadaveric study. Folia Morphol. 2017 [Epub ahead of print]; 76: 660–667.
  19. Perera J. Anatomy of the origin of the deep femoral artery. Ceylon Med J. 1995; 40(4): 139–141.
  20. Prakash , Kumari J, Kumar Bhardwaj A, et al. Variations in the origins of the profunda femoris, medial and lateral femoral circumflex arteries: a cadaver study in the Indian population. Rom J Morphol Embryol. 2010; 51(1): 167–170.
  21. Rajani SJ, Ravat MK, Rajani JK, et al. Cadaveric Study of Profunda Femoris Artery with Some Unique Variations. J Clin Diagn Res. 2015; 9(5): AC01–AC03.
  22. Siddharth P, Smith NL, Mason RA, et al. Variational anatomy of the deep femoral artery. Anat Rec. 1985; 212(2): 206–209.
  23. Sinnatamby C. Last’s anatomy: regional and applied. Churchill Livingstone Elsevier, Toronto 2006.
  24. Tanyeli E, Uzel M, Yildirim M, et al. An anatomical study of the origins of the medial circumflex femoral artery in the Turkish population. Folia Morphol. 2006; 65(3): 209–212.
  25. Tomaszewski KA, Henry BM, Vikse J, et al. The origin of the medial circumflex femoral artery: a meta-analysis and proposal of a new classification system. PeerJ. 2016; 4: e1726.
  26. Tomaszewski KA, Vikse J, Henry BM, et al. The variable origin of the lateral circumflex femoral artery: a meta-analysis and proposal for a new classification system. Folia Morphol. 2017; 76(2): 157–167.
  27. Uzel M, Tanyeli E, Yildirim M, et al. An anatomical study of the origins of the medial circumflex femoral artery in the Turkish population. Folia Morphol. 2008; 67(3): 226–230.
  28. Vazquez MT, Murillo J, Maranillo E, et al. Patterns of the circumflex femoral arteries revisited. Clin Anat. 2007; 20(2): 180–185.
  29. Vuksanović-Božarić A, Abramović M, Vučković L, et al. Clinical significance of understanding lateral and medial circumflex femoral artery origin variability. Anat Sci Int. 2018; 93(4): 449–455.
  30. Zlotorowicz M, Czubak-Wrzosek M, Wrzosek P, et al. The origin of the medial femoral circumflex artery, lateral femoral circumflex artery and obturator artery. Surg Radiol Anat. 2018; 40(5): 515–520.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., Grupa Via Medica, Świętokrzyska 73, 80–180 Gdańsk, Poland

tel.: +48 58 320 94 94, faks: +48 58 320 94 60, e-mail: viamedica@viamedica.pl