Femoral bifurcation

The femoral bifurcation refers to the anatomical point at which the common femoral artery (CFA) divides into its two terminal branches: the superficial femoral artery (SFA) and the deep femoral artery (profunda femoris artery, PFA). The CFA itself is the continuation of the external iliac artery, beginning at the origin of the inferior epigastric artery and extending distally to this bifurcation point. The branching pattern of the profunda femoris and its circumflex branches is subject to considerable normal anatomical variation. In approximately 81% of individuals, both the medial and lateral circumflex femoral arteries arise directly from the profunda femoris artery, which is situated lateral or posterolateral to the superficial femoral artery.

This bifurcation is a critical anatomical landmark in clinical practice, particularly for:

• Femoral arterial access during cardiac catheterization and other interventional procedures, where puncture should be performed in the CFA above the bifurcation to allow compression against the femoral head and reduce vascular complications (pseudoaneurysm, arteriovenous fistula).

• Peripheral artery disease evaluation, as the bifurcation region is subject to complex hemodynamic forces (recirculation zones, oscillatory shear stress) that may contribute to atherosclerosis development.

• Femoral nerve block procedures, where the first bifurcation of the femoral artery serves as the distal border for ultrasound-guided approaches.