14 Femoral Artery Anatomy

• Superficial femoral artery: 5.2 mm (2.5 – 9.6 mm)
Ref.: Spector, K. S. et al. “Optimizing safe femoral access during cardiac catheterization”. Catheterization and Cardiovascular Interventions 53;2:209-12 (2003).
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ANATOMICAL LANDMARKS
Anterior superior iliac spine (ASIS) Pubic tubercle
Inguinal ligament
Common femoral artery
CRANIAL / SUPERIOR
- towards the head
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PEDAL PULSES
Posterior tibial pulse
Dorsalis pedis pulse
Images adapted from LifeArt, Grant’s Atlas.
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CRANIAL / SUPERIOR
- towards the head
Baidu Nhomakorabea
Image source: www.ibiblio.org. Ibiblio the public’s library and digital archive.
© 2007 Radi Medical Systems AB 60478 Rev. 03 2007-09
POSTERIOR
- back of the body
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MEDIAL
- middle of the body
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THE FEMORAL SHEATH
The femoral sheath contains the femoral artery and vein.
Figure: Femoral sheath.
Figure: Right thigh.
Image source: Grant’s Atlas.
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Common femoral artery (CFA)
Vein
Image source: LifeArt.
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HOW BIG IS THE FEMORAL ARTERY?
Inner diameter (lumen): • Common femoral artery: • Deep femoral artery: 6.6 mm (3.9 – 8.9 mm) 4.9 mm (2.7 – 7.6 mm)
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MAGNETIC RESONANCE IMAGE
Femoral artery Psoas major muscle Pressure Compressed femoral vein
Bone
Bone
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LOCATION OF BIFURCATION
• Average*: 5.5 ±8.7 mm below inferior margin of femoral head
* 76% of the time
DISTAL
- away from the center or source
Image source: Jens Michael Exsteen, MD, KarKirurgisk afsnit och Klinisk-fysiologisk afd., Hillerod Sygehus, Denmark.
”N – A – V”
Anterior aspect of the right thigh 1. Sartorius 2. Iliacus 3. Femoral nerve 4. Femoral artery (Lateral to medial) 5. Femoral vein 6. Pectineus 7. Adductor longus 8. Great saphenous vein 9. Gracilis 10. Apex of femoral triangle
Figure: Right thigh.
Image source: Gray’s Anatomy of the Human Body.
© 2007 Radi Medical Systems AB 60478 Rev. 03 2007-09
Deep femoral artery (profunda)
ANATOMICAL LANDMARKS
Femoral head
Common femoral artery
Image sources: Human Anatomy Online, LifeArt.
© 2007 Radi Medical Systems AB 60478 Rev. 03 2007-09
ANATOMY
External iliac artery Inguinal ligament Skin crease
ANATOMY
SUPINE
- lying face-up
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© 2007 Radi Medical Systems AB 60478 Rev. 03 2007-09
ANTERIOR
- front of the body
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ANATOMICAL LANDMARKS
ASIS (anterior superior iliac spine) Inguinal ligament Femoral head Common femoral artery Pubic tubercle Femoral bifurcation Superficial femoral artery
Figure: Right thigh.
Ref.: Spector, K. S. et al. “Optimizing safe femoral access during cardiac catheterization”. Catheterization and Cardiovascular Interventions 53;2:209-12 (2003). Image source: Versalius.com.
Anterior superior iliac spine
Superior pubic ramus
Pubic tubercle
Image sources: Human Anatomy Online, Grant’s Atlas, LifeArt.
© 2007 Radi Medical Systems AB 60478 Rev. 03 2007-09
LATERAL
- towards the right or the left side of the body
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© 2007 Radi Medical Systems AB 60478 Rev. 03 2007-09
Figure: Right thigh.
Fluoroscopic image courtesy of Iwar Sjögren, MD, Falu Hospital, Falun, Sweden.
RETROGRADE
- against the flow
Figure: Right thigh.
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© 2007 Radi Medical Systems AB 60478 Rev. 03 2007-09
© 2007 Radi Medical Systems AB 60478 Rev. 03 2007-09
CORRECT DOME POSITIONING
Femoral artery FemoStop® dome Femoral head ≈ Arterial puncture Inguinal ligament Introducer sheath ≈ Skin incision Pubic ramus
ANTEGRADE
- with the flow
Figure: Right thigh.
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© 2007 Radi Medical Systems AB 60478 Rev. 03 2007-09
The femoral (”Scarpa’s”) triangle
Figure: Right thigh.
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2
34
5 6 7
9
ANATOMY
The common femoral artery runs directly over the medial third of the femoral head in more than 70% of individuals.
Figure: Right thigh.
MR image courtesy of Gunnar Åström, MD, Uppsala University Hospital, Sweden. Small images: LifeArt.
© 2007 Radi Medical Systems AB 60478 Rev. 03 2007-09
ANATOMY
The psoas major muscle lies behind the common femoral artery, between the artery and bone.
Common femoral artery Psoas major
Image sources: Gray’s Anatomy, LifeArt