International Journal of Anatomical Sciences 2013, 4(1):3-8

Research Paper

Profunda Femoris Artery and its Branching Pattern and Variations

Eswari AK, Hemanth Kommuru, Satyalakshimi V, Swayam Jothi S.

Department of Anatomy, Shri Sathya Sai Medical College & Research Institute, Ammapettai, Nellikuppam – 603 108, Tamil Nadu, India.

Key words: Profunda femoris artery, Variations, Medial circumflex artery, Lateral circumflex artery &
Perforators

Abstract: Profunda femoris artery is the main artery of the posterior compartment of thigh. 40 adult specimens and 10 foetal specimens were dissected and the level of origin of Profunda femoris artery in adult cadavers varied from 2 cms to 9 cms from midpoint of inguinal ligament and 0.8 cms to 1 cms in fetuses. In the adult in 4 specimens Lateral circumflex femoral artery was arising from Femoral artery, and in 5 specimens Medial circumflex was arising from Femoral artery & out of 10 fetus specimens in 8 specimens Medial & Lateral circumflex femoral arteries were arising from the Femoral artery and in two specimens from the Profunda femoris artery. All the Perforating arteries were arising from Profunda femoris except in 1 adult specimen where the second perforator was arising from Femoral artery. Profunda femoris artery is an important large branch of Femoral artery taking part in the longitudinal anastomoses at the back of the thigh. Thorough knowledge about the normal course and the variations of Arteria profunda femoris is essential for the vascular and orthopaedic surgeons and hence a detailed study of this artery was undertaken.

 Profunda femoris artery (deep femoral artery) is an important large branch of femoral artery 3.5 cm distal to the taking part in the longitudinal anastomoses at the back of the thigh. Since superficial femoral artery occlusion is more common, surgical exposure of the Profunda femoris artery is often necessary in vascular reconstructive procedures. Management of groin sepsis involving the Femoral artery requires removal of infected tissue or prosthetic material and restoration of blood flow in many cases through the Profunda femoris artery.

The knowledge about the normal Profunda femoris artery and its variations are very important for the vascular surgeon according to which he can modify the surgical procedure in a more satisfactory way. This will help him to prevent most of the common post operative complications. A thorough knowledge about the normal course and its variations were essential.

Hence a detailed study of the profunda femoris artery and its variations in the branching pattern was undertaken.

Materials and Methods

40 thigh specimens from adult human cadavers and 10 thigh specimens from dead born fetuses were made use of. Conventional dissection method was used for the study

Observations

 Observations were made under the following headings:

i. The level of origin of profunda femoris artery from the midpoint of inguinal ligament.

ii. Relation of origin of profunda femoris artery to femoral artery

iii. Branches

The distance of origin of the profunda femoris artery from the midpoint of the inguinal ligament ranged from 0.2 to 9 cm with an average 3.88 cm in adult cadavers (Table 1). In 36 specimens the distance of the origin of the profunda femoris artery from the midpoint of the inguinal ligament was less than 3.88 cm & in four specimens it was more than 3.88 cm (Table 2)(Fig.1).

In the dead born fetuses the origin of the Profunda femoris artery from the midpoint of the inguinal ligament ranged from 0.80 to 1.00cms with an average of 0.94 cm in length (Table 3) (Fig. 2). In four specimens origin of Profunda femoris from the midpoint of the inguinal ligament was less than 0.94 cm and in 6 specimens it was more than 0.94 cm. 38(95%) out of 40 adult specimens had the normal posterolateral origin (Fig. 3) and two (5%) of them had a more lateral origin (Fig. 4) (Table 4) from the femoral artery.

In all the 10 fetus specimens the profunda femoris artery was arising from the lateral side of the Femoral artery.

Regarding the branches, in 35(87.5%) out of 40 specimens of adult cadavers the Medial circumflex femoral artery was arising from the posteromedial side of the profunda femoris artery (Fig. 5). In 5(12.5%) specimens it was arising directly from the Femoral artery (Fig. 6) (Table 5). In 36(90%) out of 40 specimens Lateral circumflex femoral artery was arising from the profunda femoris artery (Fig. 7). In four (10%) specimens it was arising from Femoral artery (Fig. 8) (Table 6).

Table – 2

In 2(20%) out of 10 fetus specimens the Lateral & Medial circumflex femoral arteries were arising the Femoral artery (fig 9) and in the rest of the eight specimens (80%) they were arising from the Profunda femoris artery.

Table – 3

In 34 (85%) specimens the Lateral circumflex femoral artery gave three branches – ascending, transverse & descending (Fig. 7, 8). In 6 (15%) speci- mens four branches were arising – 1 ascending, 2 transverse and 1 descending (Table 7) (Fig. 10).

Table 4

Table – 5

All the perforating arteries were arising from profunda femoris (Fig. 11) except in 1 adult specimen where the second perforator was arising from Femoral artery (Fig. 12) (Table 8).

Table – 6

Table – 7

Table – 8

Discussion

A number of scientists have worked on this area. According to them the origin ranged from 1 to 9.7 cm. In the present study the distance varied from 2 to 9 cm with an average distance of 3.88 cm. The present finding in the South Indian cadavers coincided with that of others (Susan, 2005; Wood Jones, 1953; Boilean Grant, 1958; Gene et al. 1995; Sinnatamby, 1999).

According to Hollinshed (1957), Gene (1995), the origin of profunda femoris artery was posterolateral in 95% cases so also in the present study. The more lateral origin seen in 5% of cases coincides with that of Susan (2005) and Sinnatamby (1999).

Medial circumflex femoral artery was arising from the profunda femoris artery in 84.5% cases and in 12.5 % from the Femoral artery and these findings were similar to that of Gene (1995).

According to Hollinshed, Lateral circumflex was arising from the profunda femoris in 90% of the cases and in 10% from the Femoral artery and the present study reveals the same percentage of incidence. The Lateral circumflex artery giving more than three branches in 15% of the specimens was not reported by the earlier workers.

In 95% of the specimens three perforators were seen arising from the profunda agreeing with the findings of many authors. In 5% of the specimens, the 1st and 3rd perforators were arising from the profunda femoris and the 2nd arising from the Femoral artery. This was rare and was not documented so far.

Fig.1 Right side long distance of origin of profunda femoris in adult cadavers(More than average distance 3.88cm)	Fig.2 In fetus origin of profunda femoris from femoral artery was close to the midpoint of inguinal ligament
(PFA – profunda femoris artery, FA – femoral artery)	(FA – femoral artery,FV – femoral vein, PFA – profunda femoris artery)
Fig.3 Right side normal posterolateral origin of PFA from femoral artery. IL – Inguinal liganment	Fig.4 Right side – Lateral origin of PFA from femoral artey
(FA – femoral artery, MIP – Mid inguinal Point, PFA – profunda femoris artery)	(MIP – Mid inguinal Point, FA – femoral artery, FV – femoral vein, PFA – profunda femoris artery)
Fig.5 Left side MCFA from PFA; PFA-Profunda femoris artery	Fig.6 Right side MCFA from FA directly(cut end seen)
(MCFA – medical circumflex femoral artery)	(MCFA – medical circumflex femoral artery, FA – femoral artery)
Fig.7 Left side LCFA from PFA with 3 branches	Fig.8 Right side LCFA – from femoral artery with 3 branches
(PFA – profunda femoral artery,LCFA – lateral circumflex femoral artery)	(LCFA – lateral circumflex femoral artery, FA – femoral artery)
Fig.9 In fetus on the right side LCFA and MCFA from the femoral artery	Fig.10 Right side 4 branches from LCFA
(LCFA – lateral circumflex femoral artery, FA – femoral artery, MCFA – medical circumflex femoral artery)	(LCFA – lateral circumflex femoral artery, FA – femoral artery)
Fig.11 Right side PFA with 3 preforators – Normal	Fig.12 3-Preforators coming from the profunda femoris & second preforator was coming from the femoral artery
(PFA – Profunda femoris artery, 1,2,3-Preforators)	(PFA – Profunda femoris artery, FA – femoral artery)

Conclusion

The profunda femoris artery is the artery of the posterior compartment and the knowledge about its variation is immaterial for orthopedic and vascular surgeons. In addition to the variations reported by the earlier authors, the present study revealed four branches arising from Lateral circumflex artery and the 2nd perforating artery arising from the Femoral artery.

References

Standring S (2005) Grays Anatomy – The anatomical basis of clinical practice, 39th edition. Churchill Livingstone, London, UK. 2671-2672.

Jones FW (1953) Buchanans manual of anatomy 8th
edition. Literary Licensing. 584-590.

Grant JCB (1957) The anatomy of the respiratory blood vascular and lymphatic systems. Oxford University Press, London, UK. 2317-1320.

Grant JCB (1958) The method of anatomy descriptive and deductive. 6th edition. Oxford University Press, London, UK. 424-427.

Colborn GL, Mattar SG, Taylor B, Skandalakis JE, Lumsden AB (1995) The surgical anatomy of the deep femoral artery. The American surgeon,61: 336:346.

Sinnatamby CS (1999) Last’s Anatomy, 10th Edition.
Churchill Livingstone, London, UK. 114–115.

Hollinshed WH (1957) Anatomy for surgeons- back and limbs, 2nd edition. Harper 724-729.