Femoral Vein: Anatomy, Tributaries, and Clinical Importance

The femoral vein is the principal deep venous channel of the thigh, continuing the popliteal vein and becoming the external iliac vein at the inguinal ligament.

Anatomical Course

• Begins at adductor canal (Hunter's canal) as continuation of popliteal vein.
• Runs in femoral sheath (medial compartment), anteromedial to femoral artery.
• Passes under inguinal ligament → external iliac vein.

Major Tributaries

• Profunda femoris (deep femoral) vein: Largest; drains deep thigh muscles.
• Great saphenous vein: Superficial; joins at saphenofemoral junction (SFJ) — key varicose vein site.
• Superficial circumflex iliac, superficial epigastric, external pudendal veins.

Clinical Significance

• DVT: Common site (proximal DVT); risk of PE. Diagnosed by compression ultrasound.
• Central access: Femoral vein catheterization (emergency, difficult access); higher infection/thrombosis risk vs. subclavian/IJ.
• Saphenofemoral junction: Target for varicose vein ablation (RFA, laser, glue).
• Arteriography access: Retrograde femoral artery puncture; femoral vein compression for hemostasis.

Key Relationship

NAVEL (lateral to medial): Nerve, Artery, Vein, Empty space, Lymphatics. Vein is medial to artery in femoral triangle.