The femoral artery is a large

artery An artery (plural arteries) () is a blood vessel in humans and most animals that takes blood away from the heart to one or more parts of the body (tissues, lungs, brain etc.). Most arteries carry oxygenated blood; the two exceptions are the pu ...

in the

thigh In human 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 ...

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

profunda femoris artery The deep artery of the thigh, (profunda femoris artery or deep femoral artery) is a large branch of the femoral artery. It travels more deeply (posteriorly) than the rest of the femoral artery. Structure The deep artery of the thigh branches of ...

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 rot ...

. 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. It extends from the apex of the femoral triangle to the adductor hiatus. Structure The adductor canal exte ...

, 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 poplitea ...

in the

adductor magnus Adductor may refer to: * One of the anatomical terms of motion Motion, the process of movement, is described using specific anatomical terms. Motion includes movement of organs, joints, limbs, and specific sections of the body. The terminolo ...

near the junction of the middle and distal thirds of the thigh.

Structure

The femoral artery enters the thigh from behind the inguinal ligament as the continuation of the

external iliac artery The external iliac arteries are two major 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 artery. Th ...

. Here, it lies midway between the

anterior superior iliac spine The anterior superior iliac spine (abbreviated: 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 ing ...

and the symphysis pubis (Mid-inguinal point).

Segments

Common femoral and subsartorial artery and vein

In clinical parlance, the femoral artery has the following segments: *The common femoral artery (CFA) is the segment of the femoral artery between the inferior margin of the inguinal ligament and the branching point of the

deep femoral artery The deep artery of the thigh, (profunda femoris artery or deep femoral artery) is a large branch of the femoral artery. It travels more deeply (posteriorly) than the rest of the femoral artery. Structure The deep artery of the thigh branches of ...

/profunda femoris artery. Its first three or four centimetres are enclosed, with the

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

, 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 vertical ...

. In 65% of people, the common femoral artery lies anterior to the femoral vein in the upper thigh. *The subsartorial artery or superficial femoral artery are designations 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. It extends from the apex of the femoral triangle to the adductor hiatus. Structure The adductor canal extends ...

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

physician A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...

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 enla ...

indicates anticoagulant or

thrombolytic therapy Thrombolysis, also called fibrinolytic therapy, is the breakdown (lysis) of blood clots formed in blood vessels, using medication. It is used in ST elevation myocardial infarction, stroke, and in cases of severe venous thromboembolism (massive p ...

, but the adjective ''"superficial"'' leads many physicians to falsely believe it is a superficial vein, which has resulted in patients with femoral thrombosis being denied proper treatment. Therefore, the terms ''subsartorial artery'' and ''subsartorial vein'' are sometimes used for the femoral artery and vein, respectively, distally to the branching points of the deep femoral artery and vein. The subaortorial artery passes through the

to enter

popliteal fossa The popliteal fossa (also referred to as hough, .html" ;"title="/sup>">/sup> 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 ...

and continue as

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

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

, the pectineus, 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 adduct the thigh and it is innervated by the obturator nerve. It forms the medial wall of the fem ...

. 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. Structure The femoral nerve is the major nerve supplying the anterior compartment of the thigh. It is the largest ...

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 The superficial external pudendal artery (superficial external pudic artery) is one of the three pudendal arteries. It arises from the medial side of the femoral artery, close to the superficial epigastric artery and superficial iliac circumflex ar ...

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 is ...

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 The perforating arteries, usually three in number, are so named because they perforate the tendon of the Adductor magnus to reach the back of the thigh. They pass backward close to the linea aspera of the femur under cover of small tendinous arche ...

. At its origin, it gives off the medial and lateral circumflex femoral arteries, and during its course it gives off three perforating arteries.

Subaortorial artery/superficial femoral artery

* The

descending genicular artery The descending genicular artery (highest genicular artery) arises from the femoral artery just before it passes through the adductor hiatus. It immediately divides into two branches: * a saphenous branch, which classically joins with the medial i ...

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 on the inguinal ligament, halfway between the anterior superior iliac spine (ASIS) and the pubic symphysis. It is not to be confused with the midpoint of the inguinal ligament itself, which is located halfway ...

, halfway between the pubic symphysis and anterior superior iliac spine. Presence of a ''femoral pulse'' indicates a systolic blood pressure 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 perfor ...

. 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 (/ˈkæθətər/) 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 surgi ...

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, 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 an abnormal narrowing of arteries other than those that supply the heart or brain. When narrowing occurs in the heart, it is called coronary artery disease, and in the brain, it is called cerebrovascular disea ...

. When it is blocked through

atherosclerosis Atherosclerosis is a pattern of the disease arteriosclerosis in which the wall of the artery develops abnormalities, called lesions. These lesions may lead to narrowing due to the buildup of atheromatous plaque. At onset there are usually no s ...

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 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 be a nidus ( ...

, 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 inguinal ligament. (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:Gray548.png, 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