Patency of the descending branch of the lateral circumflex femoral artery in patients with vascular disease.

Abstract

Although the anatomy of the descending branch of the lateral circumflex femoral artery has been well described, the reliability of this vessel in patients with vascular disease has not been established. The authors sought to determine the patency of this vessel in patients with suspected lower extremity vascular disease by studying a series of lower extremity angiograms. The authors retrospectively reviewed 72 angiograms and medical records of 49 patients with suspected lower extremity vascular disease. The degree of stenosis in each of the major lower extremity arteries including the descending branch of the lateral circumflex femoral artery was measured using an established scoring system. A nonparametric Mann-Whitney test was used to determine any correlation between vessel stenosis and comorbid conditions. The most common comorbidities were peripheral vascular disease (86 percent), hypertension (80 percent), and diabetes (59 percent). Mean stenosis of the descending branch of the lateral circumflex femoral artery was 10 percent. Other vessels demonstrated mean percentage stenoses greater than 50 percent, except for the profunda femoris (12.5 percent). The descending branch showed no atherosclerotic changes in 87 percent, mild changes in 4.5 percent, moderate changes in 1.5 percent, and severe disease in 7 percent. Stenosis of this vessel was not predicted by any particular patient demographic. The descending branch of the lateral circumflex femoral artery appears to be relatively spared from atherosclerosis, providing the reconstructive surgeon with multiple flap choices based on the versatility of this system. The yield of preoperative angiography for discovering severe stenosis in patients with multiple comorbidities is low, approximately 7 percent.