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Femoral vein

The femoral vein is the main deep vein of the lower limb, responsible for draining blood from the thigh and lower extremity into the external iliac vein. It begins at the adductor hiatus as the continuation of the popliteal vein, ascends through the adductor canal and femoral triangle, and terminates posterior to the inguinal ligament where it becomes the external iliac vein.

Along its course, the femoral vein receives multiple tributaries including the profunda femoris vein (deep femoral vein), great saphenous vein (at the saphenofemoral junction), medial and lateral circumflex femoral veins, and muscular branches from the thigh.

Anatomically, the femoral vein lies medial to the femoral artery within the femoral sheath in the upper thigh, making it an important landmark in catheterization, vascular access, and surgical procedures.

Synonyms

  • Vena femoralis

  • Deep vein of thigh

  • Superficial femoral vein (older, clinically misleading term)

Function

  • Principal deep venous drainage of the lower limb

  • Receives venous return from the superficial venous system (via GSV) and deep venous system (via profunda femoris)

  • Provides a route for venous return from thigh to pelvis

  • Clinically relevant in deep vein thrombosis (DVT), catheterization, trauma, and varicose vein surgery

MRI Appearance

T1-weighted images:

  • Vein appears as a hypointense tubular lumen adjacent to femoral artery

  • Surrounded by intermediate-to-high signal fat for contrast

T2-weighted images:

  • Flowing blood: signal void

  • Thrombosis: lumen appears hyperintense, with loss of normal flow void

STIR:

  • Suppresses fat, making femoral vein more conspicuous

  • Highlights perivenous edema or inflammation in thrombophlebitis

T1 Fat-Suppressed Post-Gadolinium:

  • Enhances brightly, outlining lumen and tributaries

  • Thrombosed vein: shows non-enhancing filling defect with possible perivenous enhancement

MRV (Magnetic Resonance Venography):

  • Normal vein: lumen enhances bright hyperintense with contrast

  • DVT: intraluminal filling defect with expansion of vein, absent enhancement

  • Provides excellent mapping of femoral vein and connections with profunda femoris and GSV

  • Used in DVT diagnosis, preoperative venous mapping, and vascular anomalies

CT Appearance

Non-contrast CT:

  • Vein difficult to distinguish without contrast

  • May appear as a faint tubular soft tissue density along medial thigh

CT Post-Contrast:

  • Enhances as a clear venous channel

  • Useful in identifying vein displacement, extrinsic compression, or tumor invasion

CTV (CT Venography):

  • Normal vein lumen: enhances as bright hyperdense structure

  • Thrombosis: filling defect within enhancing vein, sometimes with surrounding inflammation

  • 3D reconstructions delineate course from popliteal vein → femoral vein → external iliac vein

  • Critical in DVT mapping, trauma evaluation, and surgical/IVC filter planning

CT image

femoral vein CT axial image

MRI images

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Femoral vein CT AXIAL IMAGE 1

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Femoral vein CT AXIAL IMAGE 2

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Femoral vein CT AXIAL IMAGE

MRI image

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MRI image

Femoral vein MRI AXIAL anatomy image-img-00000-00000_00001

MRI image

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