Rare variations of origin and course of the medial circumflex femoral artery: Report of 3 cases

Abstract

Introduction: The medial circumflex femoral artery (MCFA) arises from the deep femoral artery. It leaves the femoral triangle passing between the iliopsoas muscle and the pectineus muscle. It provides most of the arterial vascularization of the femoral head and neck. Variations in the course of the MCFA are rare and can lead to iatrogenic complications such as iatrogenic arteriovenous fistulas. Case report: During routine dissections on the femoral triangle with medical students, three cases of rare variations of origin and course of MCFA were observed. In case 1, the MCFA originated from the femoral artery by a common trunk with the inferior epigastric and obturator arteries, and passed in front of the femoral vein. In case 2, it originated from the femoral artery and left the femoral triangle passing between the pectineus muscle and the adductor longus muscle. In case 3, it originated from the lateral aspect of the femoral artery by a common trunk with the deep iliac circumflex artery and descended vertically between the femoral artery and the femoral nerve before passing between the iliopsoas muscle and the pectineus muscle. Conclusion: Variations in the course of MCFA are rare. Cardiovascular surgeons, traumatologists and general surgeons must be aware of these variations to avoid iatrogenic complications such as arteriovenous fistulas and intraoperative and postoperative bleeding. For the success of certain procedures such as catheterization and the reduction of iatrogenic complications, ultrasound-guided vascular cannulation is recommended.

Keywords

• Medial circumflex femoral artery
• Femoral vein
• Anatomical variation
• Arteriovenous fistula