Deep Femoral Vein

vena profunda femoris

The deep femoral vein (profunda femoris vein) accompanies the deep femoral artery in the medial thigh, draining the adductor and posterior thigh compartments through medial and lateral circumflex femoral tributaries and the perforating veins. It joins the femoral vein approximately 4 cm below the inguinal ligament. It is a large deep vein that participates in thigh DVT when the main femoral vein thromboses propagates into the deep femoral territory.

Region: Thigh

Clinical Relevance

Clinical Notes

The deep femoral vein is the main collateral pathway when the common femoral or superficial femoral vein is occluded by thrombus or surgical ligation. In chronic venous insufficiency and post-thrombotic syndrome, reconstruction of the common femoral vein at its junction with the deep femoral vein (common femoral vein endarterectomy or patch venoplasty) aims to restore outflow for the deep femoral territory. The deep femoral vein is identified on venous duplex ultrasound as a vessel paralleling the deep femoral artery in the proximal medial thigh.

Pathology

Common Injuries & Conditions

Deep Femoral Vein DVT

Thrombus in the deep femoral vein as part of proximal lower extremity DVT contributes to the overall thrombus burden and is associated with a higher risk of pulmonary embolism; anticoagulation duration and thrombolysis decisions consider the extent of deep femoral involvement.

Deep Femoral Vein Injury in Hip Surgery

Posterior hip approaches and proximal femoral fracture fixation involve dissection adjacent to the deep femoral vein, which can be injured during medial retractor placement, particularly at the level of the lesser trochanter where the vein is at risk from plating instruments.