Anatomical variations of the femoral vein

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Anatomical variations of the femoral vein Jean-François Uhl, MD, Claude Gillot, MD, Maxime Chahim, MD Journal of Vascular Surgery Volume 52, Issue 3, Pages 714-719 (September 2010) DOI: 10.1016/j.jvs.2010.04.014 Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 1 The 3 “angioguiding” nerves of the lower limb. Sciatic nerve or axial nerve (in yellow), femoral nerve or pre-axial nerve (in orange), and the post-axial nerve (in green). Journal of Vascular Surgery 2010 52, 714-719DOI: (10.1016/j.jvs.2010.04.014) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 2 The plexus shaped venous network of the 6th week embryo. 1, pre-axial venous plexus (in light blue); 2, axial venous plexus (in red); 3, post-axial venous plexus (in purple). A, Sciatic nerve, in yellow, B, femoral nerve, in orange, and C, small sciatic nerve, in green. Journal of Vascular Surgery 2010 52, 714-719DOI: (10.1016/j.jvs.2010.04.014) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 3 Venous network of the fetus. 1, femoral vein; 2, deep femoral vein; 3, sciatic arcade; 4, small saphenous vein; 5, dorsal (or cranial) extension of the SSV; 6, Giacomini vein; 7, great saphenous vein; s, sural nerve; P, popliteal crossroad; A, xciatic nerve (axial). Journal of Vascular Surgery 2010 52, 714-719DOI: (10.1016/j.jvs.2010.04.014) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 4 Venous network at birth. 1, femoral vein; 2, deep femoral vein; 3, sciatic arcade; 4, small saphenous vein; 5, dorsal (or cranial) extension of the SSV; 6, Giacomini vein; 7, great saphenous vein; s, sural nerve; P, popliteal crossroad; A, xciatic nerve (axial). Journal of Vascular Surgery 2010 52, 714-719DOI: (10.1016/j.jvs.2010.04.014) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 5 The three venous axis of the limb. A, axial arcade (sciatic); D, deep femoral vein; FV, femoral vein; EI, external iliac; IG, inferior gluteal vein; CF, common femoral; P1, first perforator; P2, second perforator; P3, third perforator. Journal of Vascular Surgery 2010 52, 714-719DOI: (10.1016/j.jvs.2010.04.014) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 6 The three monotruncular configurations: Dispositive A, modal anatomy (88%); Dispositive B, axiofemoral trunk (1%); Dispositive C, deep femoral trunk (2%). AFT, Axiofemoral trunk; cc, collateral canal; CF, common femoral vein; Cm, medial circonflex vein; DF, deep femoral vein; DFT, deep femoral trunk; FV, femoral vein; IG, inferior gluteal; Po, popliteal vein; SNA, sciatic nerve arcade. Journal of Vascular Surgery 2010 52, 714-719DOI: (10.1016/j.jvs.2010.04.014) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 7 Example of an axiofemoral trunk. The popliteal vein (P) comes from two roots, medial (in blue) and lateral (in green). It divides into two branches. One small femoral vein medially (FV) duplicated into two branches along the femoral artery (fa) and a large axial one (A, in red). The valves are highlighted in yellow. DF, Deep femoral vein. Journal of Vascular Surgery 2010 52, 714-719DOI: (10.1016/j.jvs.2010.04.014) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 8 Example of a deep femoral trunk. The popliteal vein (P) divides into two branches: one small femoral vein medially (F) and a large one laterally, the deep femoral trunk (D) joining the common femoral vein upward. Journal of Vascular Surgery 2010 52, 714-719DOI: (10.1016/j.jvs.2010.04.014) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 9 The four bitruncular configurations: Dispositive A, bifidity of the femoral vein (1%); Dispositive B, plexiform femoral vein (1%); Dispositive C, high bifurcation (deep femoral plus femoral; 2%); Dispositive D, low bifurcation (axiofemoral plus femoral; 4.8%). AF, Axiofemoral vein; CF, common femoral vein; DF, deep femoral vein; FV, femoral vein; P3, third perforator. Journal of Vascular Surgery 2010 52, 714-719DOI: (10.1016/j.jvs.2010.04.014) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 10 Case report of a patient with a bitruncular configuration. 3D reconstruction by veno-CT showing two main trunks of the thigh. The popliteal vein (marked 1) divides into two branches. The axiofemoral trunk (marked 2, in yellow) is the bigger, following the sciatic nerve. The femoral vein (FV) is located medially (marked 4, in blue) and divides into the deep femoral vein (marked 3, in red) at mid-thigh. 5, great saphenous vein (GSV); 6, secondary root of the FV; 7, common femoral vein. Journal of Vascular Surgery 2010 52, 714-719DOI: (10.1016/j.jvs.2010.04.014) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 11 Drawing from a dissection showing a bitruncular configuration with an FV together with a deep femoral vein (the small numbers indicate the caliber of the veins). 1, popliteal vein (in blue); 2, femoral vein (in green); 3, deep femoral vein (in yellow); 4, common femoral vein (in blue); 5, venous collateral canal; 6, popliteal artery; 7, femoral artery; 8, common femoral artery; 9, Sartorius muscle. Journal of Vascular Surgery 2010 52, 714-719DOI: (10.1016/j.jvs.2010.04.014) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 12 Case report of a dissection showing a bitruncular configuration with an FV together with an axiofemoral trunk (the small numbers indicate the caliber of the veins). Notice the X-shaped popliteal convergence. 1, medial root of the popliteal vein (in blue); 2, lateral root of the popliteal vein (in green); 3, femoral vein (in dark green); 4, axiofemoral trunk (in red); 5, deep femoral vein (in light green); 6, common femoral vein (in blue); 7, popliteal artery (in orange); 8, sciatic nerve. Journal of Vascular Surgery 2010 52, 714-719DOI: (10.1016/j.jvs.2010.04.014) Copyright © 2010 Society for Vascular Surgery Terms and Conditions