Computed Tomography Angiography-Guided Study of the Superficial Femoral Artery Course in the Thigh and the Identification of Dangerous Zones for Lateral Femoral Surgical Approaches
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Patient Selection
2.3. Imaging and Measurement Methods
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
AFC | Anterior femoral cortex |
AT | Adductor tubercle |
CT | Computed tomography |
CTA | Computed tomography angiography |
DFA | Deep femoral artery |
DMC | Distal medial condylar plateau |
FA | Femoral artery |
GT | Greater trochanter |
MFC | Medial femoral cortex |
MIPO | Minimally invasive plate osteosynthesis |
NA | Not applicable |
PFC | Posterior femoral cortex |
SD | Standard deviation |
SFA | Superficial femoral artery |
References
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Variable | Female (N: 70) Mean ± SD Min–Max | Male (N: 90) Mean ± SD Min–Max | p-Value |
---|---|---|---|
Age (year) | 58.48 ± 13.73 (20.0–81.0) | 59.24 ± 13.72 (25.0–88.0) | 0.729 * |
Femoral head–neck angle (degree) | 21.21 ± 8.97 (3.2–39.1) | 20.99 ± 8.94 (1.4–39.6) | 0.878 * |
Anteversion angle (degree) | 14.75 ± 6.56 (1.0–27.9) | 15.07 ± 6.92 (0.8–33.3) | 0.769 * |
Angle of the SFA to the condylar line at the level of the AFC (degree) | 15.66 ± 4.25 (4.2–32.5) | 17.14 ± 5.10 (1.7–40.5) | 0.349 * |
Angle of the SFA to the condylar line at the level of the PFC (degree) | −35.33 ± 10.16 (−55.7–−10.3) | −37.55 ± 12.09 (−79.2–−18.0) | 0.219 * |
Anatomical Reference Level | Distance to AT (mm) Mean ± SD | Distance to Distal Medial Condyle (mm) Mean ± SD | Distance to Femoral Cortex (mm) Mean ± SD | Angle Relative to Condyles Line (Degree) Mean ± SD |
---|---|---|---|---|
Anterior femoral cortex | 223.01 ± 27.38 (156.3–293.8) | 265.04 ± 28.21 (207.0–334.5) | 27.20 ± 5.32 (15.1–40.4) | 16.49 ± 9.94 (−9.7–40.5) |
Midsagittal femoral cortex | 180.78 ± 26.83 (107.1–246.3) | 222.40 ± 27.65 (156.1–292.6) | 25.22 ± 5.52 (11.5–58.2) | NA |
Posterior femoral cortex | 128.01 ± 29.59 (54.1–200.1) | 170.13 ± 29.96 (93.9–241.7) | 22.93 ± 6.04 (7.6–38.0) | −36.58 ± 11.30 (−79.2–−10.3) |
Distance (mm) | Distance (mm) | |||||
---|---|---|---|---|---|---|
Anatomical Reference | Female (N: 70) Mean ± SD Min–Max | Male (N: 90) Mean ± SD Min–Max | p-Value | Left Side (N: 80) Mean ± SD Min–Max | Right Side (N: 80) Mean ± SD Min–Max | p-Value |
GT to AT distance | 353.09 ± 22.35 (314.1–400.9) | 393.05 ± 18.76 (347.6–443.1) | 0.000 * | 376.02 ± 28.54 (314.1–441.1) | 375.11 ± 28.53 (316.2–443.1) | 0.841 * |
GT to DMC distance | 392.83 ± 22.48 (351.0–440.0) | 435.81 ± 19.53 (394.6–485.4) | 0.000 * | 417.75 ± 30.28 (351.0–485.4) | 416.26 ± 29.56 (353.0–480.1) | 0.754 * |
Distance between SFA and AT at level of AFC | 214.25 ± 25.93 (167.7–286.7) | 229.83 ± 26.65 (156.3–293.8) | 0.000 * | 220.72 ± 28.32 (156.3–282.3) | 225.3 ± 26.38 (177.4–293.8) | 0.291 * |
Distance between SFA and DMC at level of AFC | 253.99 ± 26.11 (207.1–333.1) | 272.59 ± 26.31 (207.5–330.7) | 0.000 * | 262.45 ± 28.77 (207.0–322.9) | 266.45 ± 26.68 (214.8–333.1) | 0.363 * |
Distance between SFA and AT at level of MFC | 177.31 ± 25.83 (134.9–246.3) | 183.49 ± 27.41 (107.1–238.4) | 0.146 * | 179.56 ± 28.35 (107.1–239.0) | 182.01 ± 25.33 (136.3–246.3) | 0.567 * |
Distance between SFA and DMC at level of MFC | 216.37 ± 26.7 (167.4–292.6) | 227.09 ± 27.62 (156.1–280.7) | 0.014 * | 221.26 ± 29.09 (156.1–280.7) | 223.54 ± 26.28 (174.1–292.6) | 0.604 * |
Distance between SFA and AT at level of PFC | 129.21 ± 29.28 (66.0- 200.0) | 127.08 ± 29.96 (54.1–182.7) | 0.653 * | 126.12 ± 30.55 (66.0–198.8) | 129.9 ± 28.66 (54.1–200.1) | 0.422 * |
Distance between SFA and DMC at level of PFC | 168.56 ± 29.67 (102.0–241.7) | 171.36 ± 30.29 (93.9–229.2) | 0.559 * | 168.37 ± 31.08 (102.0–234.6) | 171.90 ± 28.89 (93.9–241.7) | 0.458 * |
Distance of SFA to femoral cortex at level of AFC | 24.86 ± 4.24 (15.1–33.2) | 29.03 ± 5.38 (16.0–40.4) | 0.000 * | 26.36 ± 5.35 (15.1–38.5) | 28.05 ± 5.18 (16.6–40.4) | 0.045 * |
Distance of SFA to femoral cortex at level of MFC | 22.84 ± 4.51 (14.0–33.1) | 27.07 ± 5.55 (11.5–38.2) | 0.000 * | 24.02 ± 5.47 (11.5–38.2) | 26.42 ± 5.33 (13.6–37.8) | 0.006 * |
Distance of SFA to femoral cortex at level of PFC | 21.92 ± 5.01 (11.3–32.1) | 23.73 ± 6.66 (7.6–38.1) | 0.051 * | 22.07 ± 5.86 (10.5–35.5) | 23.80 ± 6.13 (7.6–38.1) | 0.070 * |
SFA length between AFC and PFC levels | 85.04 ± 18.80 (55.4–152.1) | 102.74 ± 15.84 (61.1–145.0) | 0.000 * | 94.59 ± 19.29 (55.4–152.1) | 95.40 ± 19.36 (57.4–143.9) | 0.790 * |
Left Side (N: 80) | Right Side (N: 80) | |||||
---|---|---|---|---|---|---|
Anatomical Reference | Female (N: 35) Mean ± SD Min–Max | Male (N: 45) Mean ± SD Min–Max | p-Value | Female (N: 35) Mean ± SD Min–Max | Male (N: 45) Mean ± SD Min–Max | p-Value |
GT to AT distance | 353.53 ± 21.98 (314.1–400.9) | 393.51 ± 19.33 (347.6–441.1) | 0.000 * | 352.64 ± 23.03 (316.2–400.9) | 392.82 ± 18.52 (355.4–443.1) | 0.000 * |
GT to DMC distance | 393.29 ± 22.86 (351.0–440.0) | 436.78 ± 19.90 (394.8–485.4) | 0.000 * | 392.32 ± 22.42 (353.0–436.2) | 435.17 ± 19.42 (394.6–480.1) | 0.000 * |
Distance between SFA and AT the level of AFC | 210.98 ± 23.69 (167.7–269.1) | 228.29 ± 29.54 (156.3–282.3) | 0.005 * | 217.51 ± 27.95 (177.4–286.7) | 231.07 ± 23.85 (182.9–293.8) | 0.022 * |
Distance between SFA and DMC at level of AFC | 250.74 ± 24.18 (207.0–310.1) | 271.56 ± 28.99 (207.5–322.9) | 0.001 * | 257.24 ± 27.87 (214.8–333.1) | 273.42 ± 23.85 (232.0–330.0) | 0.007 * |
Distance between SFA and AT at level of MFC | 176.05 ± 25.50 (134.9–239.0) | 182.29 ± 30.39 (107.1–234.8) | 0.321 * | 178.56 ± 26.47 (136.3–246.3) | 185.42 ± 24.12 (136.4–238.4) | 0.292 * |
Distance between SFA and DMC at level of MFC | 214.34 ± 26.58 (167.4–279.8) | 226.64 ± 30.10 (156.1–280.7) | 0.056 * | 218.40 ± 27.05 (174.1–292.6) | 228.43 ± 24.79 (176.2–279.3) | 0.127 * |
Distance between SFA and AT at level of PFC | 126.11 ± 30.52 (66.0- 198.8) | 126.14 ± 30.94 (69.9–179.0) | 0.997 * | 132.30 ± 28.08 (69.0–200.1) | 128.65 ± 29.30 (54.1–182.7) | 0.509 * |
Distance between SFA and DMC at level of PFC | 165.47 ± 31.01 (102.0–234.6) | 170.62 ± 31.30 (107.8–229.0) | 0.456 * | 171.64 ± 28.39 (106.0–241.7) | 173.01 ± 29.27 (93.9–229.2) | 0.945 * |
Distance of SFA to femoral cortex at level of AFC | 23.79 ± 4.32 (15.1–33.2) | 28.37 ± 5.26 (16.0–38.5) | 0.000 * | 25.92 ± 3.94 (16.6–32.9) | 29.87 ± 5.41 (21.5–40.4) | 0.001 * |
Distance of SFA to femoral cortex at level of MFC | 21.46 ± 4.39 (14.0–33.1) | 26.01 ± 5.44 (11.5–38.2) | 0.000 * | 24.23 ± 4.24 (16.0–33.7) | 28.23 ± 5.53 (13.6–37.8) | 0.001 * |
Distance of SFA to femoral cortex at level of PFC | 20.91 ± 5.25 (12.5–32.1) | 22.97 ± 6.21 (10.5–35.5) | 0.113 * | 22.92 ± 4.59 (11.3–31.2) | 24.46 ± 7.15 (7.6–38.0) | 0.236 * |
SFA length between AFC and PFC levels | 85.87 ± 21.11 (55.4–152.1) | 102.15 ± 13.79 (71.2–145.0) | 0.000 * | 85.20 ± 16.47 (57.4–127.2) | 102.41 ± 16.88 (61.1–136.4) | 0.000 * |
Ratio | Female (N: 70) Mean ± SD Min–Max | Male (N: 90) Mean ± SD Min–Max | p-Value | Left Side (N: 80) Mean ± SD Min–Max | Right Side (N: 80) Mean ± SD Min–Max | p-Value |
---|---|---|---|---|---|---|
Ratio 1 | 0.60 ± 0.05 (0.49–0.77) | 0.58 ± 0.06 (0.40–0.78) | 0.021 * | 0.58 ± 0.06 (0.40–0.78) | 0.60 ± 0.05 (0.46–0.77) | 0.158 * |
Ratio 2 | 0.64 ± 0.05 (0.55–0.79) | 0.62 ± 0.05 (0.48–0.81) | 0.014 * | 0.62 ± 0.05 (0.48–0.81) | 0.64 ± 0.05 (0.52–0.79) | 0.169 * |
Ratio 3 | 0.50 ± 0.05 (0.40–0.68) | 0.46 ± 0.06 (0.28–0.68) | 0.000 * | 0.47 ± 0.06 (0.28–0.68) | 0.48 ± 0.05 (0.36–0.68) | 0.463 * |
Ratio 4 | 0.55 ± 0.05 (0.45–0.72) | 0.52 ± 0.05 (0.36–0.71) | 0.001 * | 0.53 ± 0.06 (0.36–0.71) | 0.53 ± 0.05 (0.42–0.72) | 0.426 * |
Ratio 5 | 0.36 ± 0.07 (0.17–0.57) | 0.32 ± 0.07 (0.14–0.51) | 0.000 * | 0.33 ± 0.07 (0.17–0.55) | 0.34 ± 0.07 (0.14–0.57) | 0.383 * |
Ratio 6 | 0.42 ± 0.07 (0.24–061) | 0.39 ± 0.06 (0.23–0.58) | 0.001 * | 0.40 ± 0.07 (0.24–059) | 0.41 ± 0.06 (0.23–0.61) | 0.381 * |
Ratio 7 | 0.24 ± 0.04 (0.16–0.39) | 0.26 ± 0.04 (0.15–0.38) | 0.004 * | 0.25 ± 0.04 (0.16–0.39) | 0.25 ± 0.04 (0.15–0.38) | 0.711 * |
GT to AT Distance (374.9 ± 30.2 mm) | GT to DMC Distance (417.0 ± 29.8 mm) | |||||
---|---|---|---|---|---|---|
n | Distance (mm) | Pearson r | p | Pearson r | p | |
Distance of SFA to femoral cortex at level of AFC | 160 | 27.2 ± 5.3 | 0.288 ** | 0.000 | 0.276 ** | 0.000 |
Distance of SFA to femoral cortex at level of MFC | 160 | 25.2 ± 5.5 | 0.344 ** | 0.000 | 0.348 ** | 0.000 |
Distance of SFA to femoral cortex at level of PFC | 160 | 22.9 ± 6.0 | 0.294 ** | 0.000 | 0.304 ** | 0.000 |
Distance between SFA and AT at level of AFC | 160 | 223.0 ± 27.3 | 0.568 ** | 0.000 | 0.535 ** | 0.000 |
Distance between SFA and AT at level of MFC | 160 | 180.7 ± 26.8 | 0.464 ** | 0.000 | 0.437 ** | 0.000 |
Distance between SFA and AT at level of PFC | 160 | 128.0 ± 29.5 | 0.244 ** | 0.000 | 0.217 ** | 0.000 |
SFA length between AFC and PFC levels | 160 | 94.9 ± 19.2 | 0.432 ** | 0.000 | 0.426 ** | 0.000 |
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Mertsoy, Y.; Kavak, Ş.; Şenol, A. Computed Tomography Angiography-Guided Study of the Superficial Femoral Artery Course in the Thigh and the Identification of Dangerous Zones for Lateral Femoral Surgical Approaches. Medicina 2025, 61, 441. https://doi.org/10.3390/medicina61030441
Mertsoy Y, Kavak Ş, Şenol A. Computed Tomography Angiography-Guided Study of the Superficial Femoral Artery Course in the Thigh and the Identification of Dangerous Zones for Lateral Femoral Surgical Approaches. Medicina. 2025; 61(3):441. https://doi.org/10.3390/medicina61030441
Chicago/Turabian StyleMertsoy, Yılmaz, Şeyhmus Kavak, and Ayhan Şenol. 2025. "Computed Tomography Angiography-Guided Study of the Superficial Femoral Artery Course in the Thigh and the Identification of Dangerous Zones for Lateral Femoral Surgical Approaches" Medicina 61, no. 3: 441. https://doi.org/10.3390/medicina61030441
APA StyleMertsoy, Y., Kavak, Ş., & Şenol, A. (2025). Computed Tomography Angiography-Guided Study of the Superficial Femoral Artery Course in the Thigh and the Identification of Dangerous Zones for Lateral Femoral Surgical Approaches. Medicina, 61(3), 441. https://doi.org/10.3390/medicina61030441