Introduction

The femoral artery is a major branch of the iliac arteries that supplies blood to the lower extremities, including the thigh and leg. This vessel plays a crucial role in maintaining the perfusion of various tissues and organs within this region. Understanding the anatomy, physiology, and clinical implications associated with the femoral artery is essential for medical professionals, particularly those involved in angiology, angiography, and interventional radiology. This course provides a comprehensive overview of the femoral artery, covering its embryological development, anatomical variations, vascular supply, physiology, clinical relevance, and diagnostic and therapeutic interventions related to this important vessel.

Embryology and Development

The formation of the femoral artery begins during embryonic development in the fourth week of gestation. The aorta bifurcates into the common iliac arteries, which subsequently branch into the internal and external iliac arteries. The external iliac artery extends downward and medially to become the femoral artery at the inguinal ligament. This process is accompanied by the development of accompanying veins (the femoral vein) and nerves (the femoral nerve).

Anatomy and Variations

The femoral artery originates from the external iliac artery, passes through the inguinal canal, and descends along the anterior aspect of the thigh. It courses lateral to the pectineus muscle and medial to the sartorius muscle before dividing into the popliteal (or tibial) artery and the profunda femoris artery approximately 10 cm above the knee joint.

Anatomical variations in the femoral artery are relatively rare but can include accessory branches, such as the inferior epigastric artery, obturator artery, or superior gluteal artery. These vessels may arise directly from the iliac arteries or the femoral artery itself. Knowledge of such variations is essential for accurate diagnostic and therapeutic interventions.

Vascular Supply

The femoral artery supplies blood to a vast region, including the muscles of the thigh, the skin, and the lower leg. Major branches of the femoral artery include:

• Superficial epigastric artery: a superficial branch that provides blood to the skin of the abdominal wall
• Deep epigastric artery: a deep branch that anastomoses with the internal iliac artery and supplies the psoas muscle
• Illiolumbar arteries: branches that supply the lumbar region and anastomose with the lumbar vessels
• Lateral circumflex femoral artery: a branch that follows the course of the sartorius muscle and provides blood to the hip joint and surrounding muscles
• Medial circumflex femoral artery: a branch that courses along the medial aspect of the femur and supplies the adductor muscles and the hip joint
• Obturator artery: an accessory branch (in approximately 20% of cases) that supplies the medial aspects of the thigh and anastomoses with the obturator vessels

Physiology

The femoral artery, like other systemic arteries, plays a crucial role in maintaining tissue perfusion by delivering oxygenated blood from the heart to various organs. The resistance within the femoral artery can be modified through vasoconstriction and vasodilation processes, allowing for adjustments in blood flow based on local metabolic demands.

Clinical Relevance

The femoral artery is often targeted in diagnostic angiography and interventional procedures due to its accessibility and the presence of significant branches supplying the lower extremities. Atherosclerosis, thrombosis, and embolism are common pathologies affecting the femoral artery, which can lead to peripheral arterial disease, ischemia, and even limb-threatening complications if left untreated.

Diagnostic and Therapeutic Interventions

Angiography, a minimally invasive imaging technique, is often used to diagnose femoral artery pathologies such as stenosis or occlusion. Endovascular interventions, including angioplasty and stent placement, may be performed to improve blood flow and alleviate symptoms of peripheral arterial disease.

Conclusion

The femoral artery plays a vital role in maintaining the perfusion of various tissues within the lower extremities. Understanding its anatomy, physiology, and clinical implications is essential for medical professionals involved in angiology, angiography, and interventional radiology. Proper recognition and management of femoral artery pathologies can lead to improved patient outcomes and limb preservation.