Autopsy and Case Reports
Autopsy and Case Reports
Autopsy Case Report

Bilateral high origin and superficial trajectory of the deep femoral artery: clinical and applied anatomy

Gabriel Deveaux; William P. Mayer

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The anatomy of the femoral triangle is explored in various approaches, ranging from pulse verification to invasive catheterization procedures. Within the femoral triangle, the deep femoral artery is one of the vessels reported to present several anatomical variations that must be considered before clinical or surgical interventions. Here, we are reporting a unique bilateral variation of the deep femoral artery for medical education purposes and reflecting on its applied, surgical, and clinical anatomy. During the dissection of the femoral triangle, we observed that the deep femoral artery originated in the vicinity of the inguinal ligament and ran in parallel with the femoral artery in a superficial trajectory on both sides of the donor. On the right side, the DFA continued superficial for 8.8 cm, with an origin of 1.2 cm inferior to the inguinal ligament. On the left side, it presented a similar anatomical arrangement, though with an origin of 1.6cm inferior to the inguinal ligament and a superficial course of 5cm. The position of the lateral circumflex femoral vein posterior to the deep femoral artery played a role in this distinctive, lengthy, and superficial presentation of the deep femoral artery. This anatomical variation directly affects surgical procedures, diagnostics, and endovascular interventions. A deep femoral artery with such a lengthy superficial trajectory can be mistakenly used for catheterization instead of the femoral artery or be injured, disrupting the main blood supply of the thigh muscles.


Anatomy, Regional, Anatomic Variation, Femoral Artery, Dissection, Case Reports


1 Federative International Programme for Anatomical Terminology (FIPAT). Terminologia anatomica. 2nd ed. Halifax; 2019 [cited 2024 Feb 5]. Available from:

2 Power JH. Surgical anatomy of the arteries, and descriptive anatomy of the heart. Dublin: Fannin and Co; 1850. 214 p.

3 Zlotorowicz M, Czubak-Wrzosek M, Wrzosek P, Czubak J. The origin of the medial femoral circumflex artery, lateral femoral circumflex artery and obturator artery. Surg Radiol Anat. 2018;40(5):515-20. PMid:29651567.

4 Benninger B. Novel femoral artery terminology: integrating anatomy and clinical procedures leading to standardized intuitive nomenclature. Clin Anat. 2014;27(7):1085-8. PMid:24677146.

5 Patel S, Lalani A, Bray J, et al. A novel clinically based classification system for the profunda femoris artery and the circumflex femoral arteries. Ann Vasc Surg. 2022;85:204-10. PMid:35339601.

6 Chand I, Singh B. Arteria profunda femoris and its variations. Ind Med Gaz. 1951;86(6):248-50. PMid:14880239.

7 Tomaszewski KA, Henry BM, Vikse J, et al. Variations in the origin of the deep femoral artery: a meta-analysis. Clin Anat. 2017;30(1):106-13. PMid:26780216.

8 Tzouma G, Kopanakis NA, Tsakotos G, Skandalakis PN, Filippou D. Anatomic variations of the deep femoral artery and its branches: clinical implications on anterolateral thigh harvesting. Cureus. 2020;12(4):e7867. PMid:32489722.

9 Claassen H, Schmitt O, Schulze M, Wree A. Deep femoral artery: a new point of view based on cadaveric study. Ann Anat. 2021;237:151730. PMid:33798692.

10 Siddharth P, Smith NL, Mason RA, Giron F. Variational anatomy of the deep femoral artery. Anat Rec. 1985;212(2):206-9. PMid:3842043.

11 Adachi B, Hasebe K, Igakubu KD. Das arteriensystem der Japaner. Kyoto: Universität zu Kyoto; 1928. [Acta scholae medicinalis].

12 Nasr AY, Badawoud MH, Al-Hayani AA, Hussein AM. Origin of profunda femoris artery and its circumflex femoral branches: anatomical variations and clinical significance. Folia Morphol. 2014;73(1):58-67. PMid:24590524.

13 Massoud TF, Fletcher EWL. Anatomical variants of the profunda femoris artery: an angiographic study. Surg Radiol Anat. 1997;19(2):99-103. PMid:9210243.

14 Qazi E, Wilting J, Patel NR, et al. Arteries of the lower limb-embryology, variations, and clinical significance. Can Assoc Radiol J. 2022;73(1):259-70. PMid:33886403.

15 Schmidt J, Paetz B, Allenberg JR. Bilateral congenital aplasia of the deep femoral arteries. Ann Vasc Surg. 1990;4(5):498-501. PMid:2223550.

16 Young AH. Abnormal arrangement of the branches of the femoral artery: note on the absence of the profunda femoris. J Anat Physiol. 1879;13(Pt 2):154-6. PMid:17231242.

17 Wacker FK, Lippert H, Pabst R. Arterial variations in humans: key reference for radiologists and surgeons: classifications and frequency. New York: Thieme; 2017.

18 Boltri F, Ardissone F, Barile C. Apropos of 2 unusual variations of origin and course of the deep femoral artery. Minerva Chir. 1979;34(9):705-8. PMid:460629.

19 Ariyanachi K, Motwani R, Chandrupatla M. Unilateral anomalous profunda femoris artery: an anatomical variation of clinical significance. Cureus. 2022;14(12):e32188. PMid:36620835.

20 Chleborad WP, Dawson DL. The profunda femoris artery: variations and clinical applications. Clin Anat. 1990;3(1):33-40.

21 Naouli H, Jiber H, Bouarhroum A. False aneurysm of perforating branch of the deep femoral artery: report of two cases. Int J Surg Case Rep. 2015;14:36-9. PMid:26217914.

22 Craxford S, Gale M, Lammin K. Arterial injury to the profunda femoris artery following internal fixation of a neck of femur fracture with a compression hip screw. Case Rep Orthop. 2013;2013:181293. PMid:24455367.

23 Biswas S, McNerney P, Kiproff P. Pseudoaneurysm of the profunda femoris artery following blunt trauma treated by endovascular coil embolization: review of two cases and relevant literature. Case Rep Emerg Med. 2017;2017:8079674. PMid:28246563.

24 Martin R, Lau HA, Morrison R, Bhargava P, Deiling K. The rising tide of Point-of-Care Ultrasound (POCUS) in medical education: an essential skillset for undergraduate and graduate medical education. Curr Probl Diagn Radiol. 2023;52(6):482-4. PMid:37479620.

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