The femoral vein is the main venous drainage of the lower limb and the primary site for femoral vein deep vein thrombosis (DVT). It lies medial to the femoral artery in the femoral sheath, accessible for central venous catheterisation via the femoral approach. The femoral vein is the preferred approach for inferior vena cava filter placement and for pulmonary angiography in the investigation of pulmonary embolism.
| Origin | Continuation of the popliteal vein at the adductor hiatus |
|---|---|
| Course | Ascends through the adductor canal posterior to the femoral artery and then through the femoral triangle on its medial side, receives the deep femoral and great saphenous veins, and becomes the external iliac vein behind the inguinal ligament |
| Branches |
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The segment between the adductor hiatus and the junction with the deep femoral vein was long called the superficial femoral vein, a misleading name because it is a deep vein; thrombosis here is a proximal DVT with a real pulmonary embolism risk, which is why current terminology simply calls it the femoral vein. Femoral vein DVT is identified on duplex ultrasound by non-compressibility of the vein, loss of normal flow variation with breathing and visible thrombus. Anticoagulation is the main treatment, and catheter-directed thrombolysis is considered for selected extensive iliofemoral clots. Post-thrombotic syndrome, with chronic swelling, skin changes and ulceration, follows in a large minority of patients despite treatment.
Deep vein thrombosis of the femoral vein producing leg swelling and pain confirmed by duplex ultrasound, managed with anticoagulation and compression to prevent post-thrombotic syndrome and pulmonary embolism.
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