E-ISSN:2456-3110

Case Report

Profunda Femoris Artery

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 8 August
Publisherwww.maharshicharaka.in

High Origin of Profunda Femoris Artery - A Case Report

Byalihal H1*, B Kanavi N2, Shwetha3
DOI: http://dx.doi.org/10.21760/jaims.8.8.43

1* Harshavrdhan V Byalihal, Professor Hod, Department of Post Graduate Studies In Rachana Shareera, Rges Ayurvedic Medical College, Ron, Karnataka, India.

2 Niyaz B Kanavi, Assistant Professor HOD, Department of Post Graduate Studies In Rachana Shareera, RGES Ayurvedic Medical College, Ron, Karnataka, India.

3 Shwetha, Post Graduate Scholar, Department of Post Graduate Studies In Rachana Shareera, RGES Ayurvedic Medical College, Ron, Karnataka, India.

Profunda Femoris Artery arises from lateral aspect of femoral artery 3.5cm distal to inguinal ligament. Profunda femoris Artery gives lateral circumflex and medial circumflex femoral arteries from lateral and medial aspect of femoral artery respectively. Following variation was reported in left lower limb of a 62-year male cadaver, during routine dissection of Rachana Shareera dissection class. Profunda Femoris Artery arises from lateral aspect of femoral artery 1.5 cm distal to inguinal ligament, runs laterally and down words parallel to femoral artery, the profunda femoris passed beneath rectus femoris, sartorius and vastus medialis successively in its course, later pierced adductor magnus, 5.5 cm above knee joint.

Keywords: Profunda femoris artery, Femoral artery, Inguinal ligament

Corresponding Author How to Cite this Article To Browse
Harshavrdhan V Byalihal, Professor Hod, Department of Post Graduate Studies In Rachana Shareera, Rges Ayurvedic Medical College, Ron, Karnataka, India.
Email: 		Byalihal H, B Kanavi N, Shwetha, High Origin of Profunda Femoris Artery - A Case Report. J Ayu Int Med Sci. 2023;8(8):270-272.
Available From
https://jaims.in/jaims/article/view/2715

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-06-07 2023-06-12 2023-06-23 2023-07-04 2023-07-19
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 18%

© 2023by Byalihal H, B Kanavi N, Shwethaand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Introduction

The profunda femoris artery provides the main blood supply to the thigh. It usually arises from the posterolateral aspect of the femoral artery3.5cm distal to inguinal ligament and descends first laterally, and then posterior to the superficial femoral artery. It gives lateral circumflex and medial circumflex femoral arteries from lateral and medial aspect respectively from femoral artery.[1] The femoral artery is second site of choice after radial artery for placement of an arterial line for certainprocedures.When easilyaccessible veins are collapsed, femoral vein is used for collection of blood. Thus, femoral triangle is clinically important and significant area for accessing vessels.[2] Shorter the distance of origin of Profunda Femoris Artery higher is the risk of iatrogenic damage of Profunda femoris Artery. Any variation in Profunda Femoris Artery should be taken in account to prevent unexpected complications.

Case Report

Following variation was reported in left lower limb of a 62 year male cadaver, during routine dissection of Rachana Shareera dissection class at RGES Ayurvedic Medical College & Hospital and Post Graduate Research Centre, Ron. Profunda Femoris Artery arose from lateral aspect of femoral artery 1.5cm distal to left inguinal ligament, running laterally and down words parallel to femoral artery the profunda femoris passed beneath rectus femoris, Sartorius and vastus medialis successively, finally pierced adductor magnus as forth perforator artery, 5.5 cm above knee joint.

Discussion

The existence of variations of the lower limb vessels can most often be explained as an abnormal development of the arterial network of the lower limb in the embryo.[2,3] Femoral artery develops from rete femorale in the ventral aspect of the thigh. It communicates with the external iliac artery above through rete pelvicum and sciatic artery below. The persistent sciatic artery grows out from fifth lumbar inter segmental artery in the dorsal part of thigh, when the embryo is about 10 mm long and ends in plantar capillary plexus. As the development proceeds, anastomosis between the axis artery and rete femorale

develops. It is generally accepted that increase of blood flow in these capillaries determines the final mature arterial pattern. Thus, the most appropriate channels enlarge while others contract and disappear.[2,3]Therefore, we can speculate that one possible reason for the observed variation in this case could be increased blood flow in the rete femorale vessels located at higher level, forming a high origin of Profunda femoris Artery and increased blood flow in the rete femorale vessels. Procedures like arteriography, Doppler imaging, vascular reconstruction of proximal leg necessitates precise anatomy of Profunda femoris Artery along with the femoral artery. Variations of Profunda femoris Artery and their awareness will definitely reduce the risk. of damaging them.

Origin of Profunda Femoris Artery is from lateral aspect of femoral artery, in 46% it is from posterior aspect, in 30% from postero lateral aspect and in 23% is from lateral aspect.[4] The distance between midpoint of inguinal ligament and origin of Profunda Femoris Artery is clinically important.

Judkin technique is undertaken where femoral artery is approached by puncturing the vessel 1 to 3cm below the inguinal ligament.[5] In 1 out of 431 cases Profunda femoris Artery was originated above the inguinal ligament, in 1.6% it was originated deep to inguinal ligament and in 3.01% cases it was originated half inch below the inguinal ligament.[6] Profunda femoris Artery gives lateral and medial circumflex femoral artery in addition to perforating branches. Lateral circumflex femoral artery gives ascending, transverse and descending branches. Variations are seen in branching pattern of Profunda Femoris Artery unilaterally and or bilaterally[7] but in this case Profunda Femoris Artery is given at a higher level than usual. The knowledge of the site of Profunda Femoris Artery origin is very important as it helps in avoiding iatrogenic femoral arteriovenous fistula while performing Femoral Artery puncture, and it enables to identify the correct site of making incision for surgical exposure of the Femoral Artery and Profunda Femoris Artery junction. Shahin et al. opined that, before the catheterization of femoral vessels and operations in the femoral triangle, high resolution ultrasonic imaging can provide anatomic and functional information about the femoral vessels and would be of assistance in planning catheterization. High origin of Profunda femoris Artery can cause problem in procedures like femoral arterial and venous puncture and


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femoral nerve blocks, because of close relationship of vessels and nerve in femoral triangle.[5] Pseudoaneurysms can occur when the puncture site is the Profunda Femoris Artery or Femoral Artery distal to the origin of the Profunda Femoris Artery.

jaims_2715_01.JPGFigure 1: Showing left Profunda Femoris Artery high origin.

jaims_2715_02.JPG

Figure 2: Showing comparison of left Profunda Femoris Artery origin.

Conclusion

During catheter application, in making flaps with pedicles, in reconstructive surgery and bypass procedures, the direction of the origin of Profunda Femoris Artery is important role.[7]

Profunda Femoris Artery diameter will decrease if the artery takes its origin more distally from Inguinal ligament. In lower limb revascularization procedures done for non-healing ulcers and/or gangrene, to relieve the claudicating pain, this high origin of the Profunda Femoris Artery knowledge is very useful. It was also explained that during plastic and reconstructive surgery this knowledge is very useful in preventing the necrosis of flap. Detail study of Profunda Femoris Artery and its branching patters can be thoroughly studied with HD ultrasonic imaging techniques before any related procedures in the femoral triangle to gain successful results.

Reference

1. Snell Richard. Clinical anatomy by regions.9th edition. Baltimore, Lippincott Williams & Wilkins, 2012pg461

2. Sahin B, Uzun A, Emirzeoglu M, Kosif R, Bilgic S 2003. A deep femoral artery passing in front of the femoral vein. Folia Morphol.62:143-6.

3. Çiftcioglu E, Kale A, Kopuz C, Edizer M, Aydln E, Demir MT 2009. Medial circumflex femoral artery with different origin and course: a case report and review of the literature. Folia Morphol. 68:188-91

4. Samarawickrama MB, Nanayakkara BG, Wimalagunarathna KW, Nishantha DG, Walawage UB. Branching pattern of the femoral artery at the femoral triangle: a cadaver study. Galle Med J. 2009;14:31-4

5. Baptist M, Hussain T, Sultana F. The origin of profunda femoris artery, its branches and diameter of the femoral International Journal of Health Sciences & Research (www.ijhsr.org) 397 Vol.5; Issue: 3; March 2015 artery. Professional Med J. 2007;14: 523-7.

6. Quain R. Anatomy of Arteries of the Human Body, London, Taylor and Walton, (1844) pg 476-8.

7. Dixit DP, Mehta LA, Kothari ML. Variations in the origin and course of profunda femoris artery. J Anat Soc India. 2001;50:6-7.


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