title: Deep and superficial circumflex iliac arteries and their relationship to the ultrasound-guided femoral nerve block procedure: A cadaver study.
abstract: The in-plane lateral to medial approach is a standard technique for ultrasound-guided femoral nerve block (USG-FNB). The first bifurcation of the femoral artery, which consists of the deep artery of the thigh (DAT) or occasionally the lateral circumflex femoral artery (LCFA), is regarded as the distal border for this procedure. We sometimes detect arteries along the estimated needle trajectory for USG-FNB. The superficial (SCIA) and deep (DCIA) circumflex iliac arteries run laterally parallel to the inguinal ligament from the femoral or external iliac artery. The relationship between the SCIA and DCIA and other anatomical structures related to USG-FNB around the femoral triangle region was studied by gross anatomical examination of 100 formalin-fixed adult cadavers. At least one SCIA and one DCIA were identified around each femoral triangle; 81.8% of SCIA and 58% of DCIA originated from the femoral artery. All DCIA coursed between the fascia lata and fascia iliaca and 80% of SCIA penetrated the fascia lata. In 94% of femoral triangles, at least one arterial branch heading towards the lateral part of the thigh originated from the femoral artery from the level of the inguinal ligament to the first bifurcation of the femoral artery. The presence of SCIA and DCIA should be considered during USG-FNB using the in-plane lateral to medial approach to avoid inadvertently injuring them, as they are occasionally located along the presumed needle trajectory superficial to the fascia iliaca. Clin. Anat. 30:413-420, 2017. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Department of Macroscopic Anatomy, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.|Department of Anesthesiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Ogami
authors.affiliation: Department of Anesthesiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Murata
authors.affiliation: Department of Anesthesiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Sakai
authors.affiliation: Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Shuntaro
authors.initials: S
authors.lastname: Sato
authors.affiliation: Department of Macroscopic Anatomy, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Saiki
authors.affiliation: Department of Macroscopic Anatomy, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Keishi
authors.initials: K
authors.lastname: Okamoto
authors.affiliation: Department of Oral Anatomy and Dental Anthropology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Manabe
authors.affiliation: Department of Anesthesiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Hara
authors.affiliation: Department of Macroscopic Anatomy, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Tsurumoto
mesh_terms: D000328:Adult; D002102:Cadaver; D005206:Fascia Lata / Q000033:anatomy & histology*; D005260:Female; D005263:Femoral Artery / Q000033:anatomy & histology*; D005267:Femoral Nerve; D006801:Humans; D007083:Iliac Artery / Q000033:anatomy & histology*; D008297:Male; D009407:Nerve Block / Q000379:methods*; D025321:Surgery, Computer-Assisted; D014463:Ultrasonography
keywords: deep circumflex iliac artery; femoral nerve block; superficial circumflex iliac artery