Femoral Artery

Indications

 

Injury to femoral artery or profunda femoris

 

On table angiogram

 

Longitudinal incision

- midpoint ASIS and pubic symphysis

- open femoral sheath

- NAVY

- insert catheter into artery

- inject contrast and follow with II

 

Exposure

 

Checroun et al J Orthop Trauma 1996

- extensile medial approach to femur

https://pubmed.ncbi.nlm.nih.gov/8892148/

 

Position

 

Patient supine

- hip abducted / extended / externally rotated with knee bent

- Figure of 4 position

 

Incision

 

Centre of the mid inguinal point

Extends over knee to 1 cm posterior border tibia

 

Dissection

 

Proximal dissection

- divide deep fascia over sartorius

- retract sartorius anteriorly to expose femoral artery

- base of femoral artery is adductor longus

 

Distal dissection

- interval between sartorius posteriorly and vastus medialis anteriorly

- expose adductor canal on adductor magnus

 

Knee

- detach medial head of gastrocnemius to expose popliteal artery

- at tibia detach soleus to expose trifurcation

 

Anastomosis

- first clear artery with embolectomy

- vein patch graft or anastomosis with reversed great saphenous vein

- repair 6.0 prolene non cutting needle