Variations in the origin of the deep femoral artery: A meta-analysis.

The deep femoral artery (DFA) is the largest branch of the femoral artery (FA) and is responsible for vascularization of the thigh muscles. Knowledge of the anatomical variations in its origin point is important for surgeons and interventional radiologists. The aim of our study was to provide a comprehensive evidence-based assessment of its anatomical properties. An extensive search through the major electronic databases was conducted to find all articles reporting data on the anatomical characteristics of the DFA. No date limits or language restrictions were imposed. A total of 25 articles (n = 2,502 lower limbs) were included in the meta-analysis. Six different patterns of origin of the DFA from the FA were identified, the most common type being a posterior origin (38.8%, 95% CI 22.8-49.5%). The DFA most commonly branched off in the proximal third of the thigh, with a prevalence of 47.6% (95% CI 35.8-59.2%). The pooled mean distance of the DFA from its point of origin to the mid-inguinal point was 41.15 mm (95% CI 32.39-53.73). The point and level of origin of the DFA from the FA varies widely in the general population. Owing to this variability, accurate anatomical knowledge regarding the DFA is crucial for clinicians if iatrogenic injuries are to be avoided during procedures in the femoral region. Clin. Anat. 30:106-113, 2017. © 2016 Wiley Periodicals, Inc.

The origin of the medial circumflex femoral artery: a meta-analysis and proposal of a new classification system.

Background and Objectives. The medial circumflex femoral artery (MCFA) is a common branch of the deep femoral artery (DFA) responsible for supplying the femoral head and the greater trochanteric fossa. The prevalence rates of MCFA origin, its branching patterns and its distance to the mid-inguinal point (MIP) vary significantly throughout the literature. The aim of this study was to determine the true prevalence of these characteristics and to study their associated anatomical and clinical relevance. Methods. A search of the major electronic databases Pubmed, EMBASE, Scopus, ScienceDirect, Web of Science, SciELO, BIOSIS, and CNKI was performed to identify all articles reporting data on the origin of the MCFA, its branching patterns and its distance to the MIP. No data or language restriction was set. Additionally, an extensive search of the references of all relevant articles was performed. All data on origin, branching and distance to MIP was extracted and pooled into a meta-analysis using MetaXL v2.0. Results. A total of 38 (36 cadaveric and 2 imaging) studies (n = 4,351 lower limbs) were included into the meta-analysis. The pooled prevalence of the MCFA originating from the DFA was 64.6% (95% CI [58.0-71.5]), while the pooled prevalence of the MCFA originating from the CFA was 32.2% (95% CI [25.9-39.1]). The CFA-derived MCFA was found to originate as a single branch in 81.1% (95% CI [70.1-91.7]) of cases with a mean pooled distance of 50.14 mm (95% CI [42.50-57.78]) from the MIP. Conclusion. The MCFA's variability must be taken into account by surgeons, especially during orthopedic interventions in the region of the hip to prevent iatrogenic injury to the circulation of the femoral head. Based on our analysis, we present a new proposed classification system for origin of the MCFA.