TY - JOUR
TI - Surgical anatomy of the lateral circumflex femoral artery branches: Contribution to the blood loss control during hip arthroplasty
AU - Totlis, T.
AU - Paparoidamis, G.
AU - Terzidis, I.
AU - Piagkou, M.
AU - Tsiridis, E.
AU - Natsis, K.
JO - Annals of Anatomy - Anatomischer Anzeiger
PY - 2020
VL - 232
TODO - null
SP - null
PB - Elsevier GmbH
SN - 0940-9602
TODO - 10.1016/j.aanat.2020.151566
TODO - aged;  anatomical concepts;  anatomical variation;  anthropometric parameters;  Article;  blood vessel diameter;  blood vessel wall;  female;  hip arthroplasty;  human;  human tissue;  lateral circumflex femoral artery;  male;  operative blood loss;  ulnar artery;  adverse event;  anatomy and histology;  cadaver;  femoral artery;  hip replacement;  operative blood loss;  sexual characteristics;  very elderly, Aged;  Aged, 80 and over;  Arthroplasty, Replacement, Hip;  Blood Loss, Surgical;  Cadaver;  Female;  Femoral Artery;  Humans;  Male;  Sex Characteristics
TODO - Background: The lateral circumflex femoral artery (LCFA) branches encountered during anterior and lateral hip approaches; although vessels’ haemostasis is suggested in surgical textbooks, literature is scarce regarding their topography. The current study defines the exact location of the LCFA and its branches, based on osseous landmarks, as well as their size and possible variants, providing helpful information for intraoperative identification and demonstrating the magnitude of potential haemorrhage during hip surgery. Methods: Twenty-three human cadavers (46 lower limbs) were dissected. The LCFA branching pattern was recorded. The distances of the LCFA origin and its first branch from the anterior superior iliac spine (ASIS) were measured. Length and width of the LFCA, LCFA ascending and transverse branches (LCFAab and LCFAtb) were calculated and compared to the ipsilateral ulnar artery (UA) width, which was served as a comparative guide. Results: The LFCA origin was located 106.9 ± 17.5 mm distal and 65.6 ± 14.7 mm medial to the ASIS, while the LFCA first branch origin was 115.1 ± 24.3 mm distal and 48.2 ± 14.3 mm medial to the ASIS. The mean lengths of the LCFA, LCFAab and LCFAtb were 23.2 ± 12.6 mm, 44.8 ± 14.9 mm and 42.3 ± 13.6 mm, respectively. Their mean widths were 4.3 ± 1.0 mm, 2.9 ± 0.9 mm and 2.7 ± 0.7 mm, respectively, while the mean UA width was 2.7 ± 0.4 mm. Conclusion: The surgeon may detect the LCFA and its branching, at a mean distance of 110 mm (range 100−126 mm), distal to the ASIS. The LCFAab and LCFAtb widths are similar to the UA width. Meticulous knowledge of the branching pattern topography and vessels’ size may contribute to a successful management of the intraoperative blood loss. © 2020 Elsevier GmbH
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