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Lateral circumflex femoral artery

The lateral circumflex femoral artery (LCFA) is a major branch of the profunda femoris artery (deep femoral artery), though it occasionally arises directly from the femoral artery. It courses laterally across the femoral nerve and vein, deep to the sartorius and rectus femoris muscles, and then divides into ascending, transverse, and descending branches.

  • Ascending branch: runs upward to the hip region, anastomosing with the superior gluteal and medial circumflex femoral arteries; contributes to the trochanteric anastomosis and supplies the lateral hip.

  • Transverse branch: runs laterally across the vastus lateralis and participates in the cruciate anastomosis with the medial circumflex femoral, inferior gluteal, and first perforating artery.

  • Descending branch: runs downward between rectus femoris and vastus lateralis; supplies vastus lateralis and participates in the genicular anastomosis around the knee.

The LCFA is clinically significant as it provides blood supply to the hip joint, thigh muscles (vastus lateralis, rectus femoris, tensor fasciae latae), and knee region. It is also the vascular pedicle for the anterolateral thigh (ALT) flap, one of the most widely used free flaps in reconstructive surgery.

Synonyms

  • Arteria circumflexa femoris lateralis

  • External circumflex femoral artery

Function

  • Supplies lateral and anterior compartments of thigh, hip joint, and knee joint

  • Provides arterial pedicle for anterolateral thigh flap in reconstructive surgery

  • Contributes to collateral circulation through trochanteric, cruciate, and genicular anastomoses

Branches

  • Ascending branch: hip and gluteal region

  • Transverse branch: participates in cruciate anastomosis

  • Descending branch: supplies quadriceps and knee region

MRI Appearance

T1-weighted images:

  • LCFA appears as a linear hypointense flow void lateral to femoral vessels, deep to sartorius and rectus femoris.

  • Surrounded by hyperintense fat, aiding identification.

T2-weighted images:

  • Normal artery: signal void

  • Aneurysms or thrombosis: altered lumen signal (hyperintense/heterogeneous).

STIR:

  • Suppresses fat, making the vessel clearer within thigh musculature.

  • Detects perivascular edema, hematoma, or inflammatory changes.

T1 Fat-Suppressed Post-Gadolinium:

  • Artery enhances brightly and homogeneously.

  • Useful for visualizing branches and anastomoses.

  • Highlights tumors or vascular malformations supplied by LCFA.

MRA Pelvis/Thigh with Gadolinium:

  • Clearly maps the origin, course, and branching pattern of LCFA.

  • Shows contributions to trochanteric, cruciate, and genicular anastomoses.

  • Useful in free flap planning, trauma, and tumor embolization mapping.

CT Appearance

Non-contrast CT:

  • Appears as a small tubular soft-tissue density; difficult to differentiate without contrast.

  • Useful for detecting vascular calcifications.

CT Post-Contrast:

  • LCFA opacifies clearly along its lateral course.

  • Detects aneurysms, stenosis, or compression by masses.

CT Angiography (CTA):

  • Gold standard for arterial mapping of LCFA.

  • 3D reconstructions show origin, course, ascending/transverse/descending branches, and anastomotic networks.

  • Essential for ALT flap planning, trauma imaging, and vascular anomaly assessment.

CT VRT 3D image

Lateral circumflex femoral artery CT 3D VRT anatomy image

CT image

Lateral circumflex femoral artery CT axial image MRI axial anatomy image-img-00000-00000

CT image

Lateral circumflex femoral artery CT axial image MRI axial anatomy image-img-00000-00000_00001

MRI image

Lateral circumflex femoral artery MRI axial image MRI axial anatomy image-img-00000-00000