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Superficial femoral artery

The superficial femoral artery (SFA) is the direct continuation of the common femoral artery (CFA) distal to the origin of the profunda femoris (deep femoral artery). Despite its name, the SFA is not superficial in position but lies deep within the thigh. The term "superficial" only distinguishes it from the profunda femoris.

The SFA descends within the femoral triangle, medial to the femoral vein and covered by the sartorius muscle as it passes through the adductor (Hunter’s) canal. It becomes the popliteal artery after emerging through the adductor hiatus.

It provides multiple muscular branches to the anterior and medial compartments of the thigh and cutaneous branches to the skin. The SFA is the main arterial supply to the lower limb distal to the knee, and is a critical site for peripheral arterial disease (PAD), atherosclerosis, endovascular interventions, and bypass grafting.

Synonyms

  • SFA

  • Continuation of the common femoral artery

  • Femoral artery (superficial segment)

Function

  • Supplies arterial blood to the anterior and medial compartments of the thigh

  • Provides distal blood supply via its continuation as the popliteal artery

  • Major contributor to lower limb perfusion and collateral circulation

  • Clinical landmark for vascular access and peripheral revascularization procedures

MRI Appearance

T1-weighted images:

  • Lumen: hypointense flow void

  • Wall: low signal, distinguishable from adjacent fat planes

  • Plaque or thrombus: may appear as intermediate-to-hyperintense within lumen

T2-weighted images:

  • Normal lumen: flow void

  • Acute thrombus: hyperintense signal

  • Chronic atherosclerotic plaque: hypointense

STIR:

  • Fat suppression enhances visualization of vessel wall edema, inflammation, or perivascular changes

  • Hyperintense thrombus or surrounding soft tissue inflammation

T1 Fat-Suppressed Post-Gadolinium:

  • Lumen: homogeneously bright enhancement

  • Stenosis: irregular narrowing with filling defects

  • Occlusion: lack of enhancement

  • Plaques and neovascularization: abnormal enhancement along vessel wall

MRA with Gadolinium (Contrast-Enhanced MRA):

  • Gold standard for non-invasive arterial imaging

  • Provides clear delineation of SFA origin, course, stenoses, occlusions, aneurysms, or dissections

  • Multiplanar and 3D reconstructions assist in endovascular and surgical planning

CT Appearance

Non-contrast CT:

  • Vessel lumen appears as soft tissue density

  • Detects calcified plaques, mural thickening, or aneurysms

CT Post-Contrast:

  • Vessel lumen enhances brightly

  • Identifies stenosis, occlusion, intraluminal thrombus, or pseudoaneurysm

CT Angiography (CTA):

  • Gold standard for arterial mapping in the lower limb

  • Provides high-resolution visualization of SFA course, branching, degree of stenosis, and distal runoff vessels

  • Detects atherosclerosis, PAD, aneurysms, dissections, or vascular trauma

  • 3D reconstructions valuable for bypass graft and stent planning

CT VRT 3D image

Superficial femoral artery CT 3D VRT anatomy image

CT image

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MRI image

superficial femoral artery MRI axial image MRI axial anatomy image-img-00000-00000