Sweat glands

The oblique branch of the lateral circumflex femoral artery (LCFA) is a distinct vascular branch located between the transverse and descending branches of the lateral circumflex femoral artery (LCFA) in the anterolateral thigh. First formally described by Wong et al. in 2009, it is present in approximately 32 to 73% of cases and courses at roughly 45° outward and downward relative to the body's long axis before gradually turning parallel to it.

Origin and course

The oblique branch has a variable origin. It may arise from the transverse branch (~52%), the descending branch (~36%), the LCFA trunk (~6%), or less commonly directly from the profunda femoris or femoral artery (~3% each). It typically runs in the plane between the rectus femoris and vastus lateralis muscles, lateral to the descending branch in the upper thigh. It consists of one artery and usually two accompanying veins, with a diameter of approximately 1 mm.

Normal anatomy vs. variant

Although traditionally considered an anatomical variant, recent evidence suggests the oblique branch may represent a normal anatomical element rather than a true variant. A 2023 study of 153 ALT flaps found that oblique branches accounted for 73.7% of all identified branches, with a significantly higher proportion arising as septocutaneous perforators compared to the descending branch. The oblique branch has also been proposed as a preferred vascular pedicle for free ALT flaps due to its high prevalence and favorable septocutaneous anatomy.