Abstract:
Introduction: The deep femoral artery (DFA) serves as a crucial „turning point” between collateral
circulation of the pelvis and that of the lower limb (LL), playing a determinant role not only in
femoropopliteal axis obstruction, but also in aortoiliac obstructive disease. Choice of the surgical
method depends on surgeon's experience, intraoperative anatomical situation and a significant role is
atributed to the variability of the deep femoral artery. The aim of our study was to investigate the
anatomical variants of the deep femoral artery depending on gender and laterality.
Materials and methods. The variability of the deep femoral artery (DFA), as the main collateral
branch of the femoral artery (FA) was studied on 40 lower limb angiographies, taken from the database
of the Endovascular Surgery Department of MSPI CRH Timofei Moșneaga. All the angiographies of
the study sample size belonged to patients without any arterial pathology. The analysis of the lower
limb arterial angiographies aimed to translate the anatomy of the DFA from the virtual model to the
real one, in order to identify its variability based on gender and laterality, according to the studied
criteria: origin, numerical variations and branching pattern.
Results. Eleven patients (27.5%) had different variants of the deep femoral artery, out of which 7
patients (17.5%) were males (12.5% with variants of the right LL and 5% with variants of the left LL),
and 4 patients (10%) were females (7.5% with variants of the right LL and 2.5% with variants of the
left LL). Variability of the DFA origin was identified in 10.0% of cases (high origin in 7.5% and low
origin in 2.5%). In 5.0% of cases numerical variants were determined and in 12.5% variants of
branching pattern were revealed. The following variants of the DFA branching pattern were
established: 1. Bifurcation of the DFA into two branches – the medial circumflex femoral artery
(MCFA) and the lateral circumflex femoral artery (LCFA), was identified in 5% of cases; 2. The DFA
gave rise to the LCFA and three perforating arteries (PA), while the MCFA in 5.0% of cases derived
from the femoral artery (FA); 3. The DFA gave rise to the MCFA and three PA, while the LCFA in
2.5% of cases started from the femoral artery (FA).
Conclusions: The deep femoral artery is more frequently variable in males, and on the right side. To
enhance the safety and efficacy of any procedures performed at the thigh level, it is crucial to be aware
of the deep femoral artery anatomical variability.
