Consistent sex-specific patterns in the anatomy of the femoral and profunda femoris arteries: a cadaveric study

Background The variation of the femoral artery and profunda femoris artery (FA and PFA) anatomy is clinically significant with regard to FA access and surgery of the femoral region. Despite the variability of these vessels having been extensively reported, sex-biased anatomical differences are yet to be more thoroughly investigated. In this work, we attempted to examine sex-specific morphometry, origin, and branching patterns of the FA and PFA from a morphometric, origin-to-branch morphology/strand-to-cross-sectional perspective.

Methods This cadaveric study analyzed 96 femoral regions obtained from 48 adult cadavers, including 24 male individuals and 24 female individuals. The FA's origin from the inguinal canal was measured bilaterally. The location of origin of the PFA was evaluated with regard to the adductor longus and sartorius muscles, and the terminal branches were recorded. Statistical analysis included independent-samples t-tests, nonparametric testing as indicated, and effect size calculations.

Results The mean distance between the origin of the FA and inguinal canal was greater in the male cadavers than in female cadavers (2.63 ± 0.38 cm vs. 2.02 ± 0.44 cm; p<0.001; Cohen’s d=1.48). There was no left-right asymmetry. Sex-specific patterns of arterial origin of PFA were found to be consistent. In female cadavers, the artery originated at the proximal one-third of adductor longus and distal half of sartorius muscle, and in male cadavers, it originated at the mid-portion of adductor longus and proximal one-third of sartorius muscle. Male cadavers had a more abundant mean number of terminal branches of the PFA (3.50 ± 0.55 vs 2.67 ± 0.52 in female cadavers), though this difference was not significant.

Conclusion This study demonstrates pronounced and consistent sex-related anatomical differences in the FA and PFA. Recognition of these differences is essential for improving the safety and accuracy of femoral artery access and for optimizing surgical planning in orthopedic, vascular, and reconstructive procedures involving the femoral region.