A medial circumflex femoral artery passing anteriorly to the femoral vein: report of a bilateral case

The passage of the medial circumflex femoral artery anterior to the femoral vein is an extremely rare anatomical variation. It can lead to an iatrogenic arteiovenous fistula after cardiac catheterization. We report here the first bilateral case of passage of the medial circumflex femoral artery anterior to the femoral vein. During a dissection on the femoral trigone in a 73-year-old male cadaver, a medial circumflex femoral artery passing anterior to the femoral vein was observed on both sides. On both sides, it originated from the anteromedial aspect of the femoral artery. It was traveling downwards and inwards. It passed anteriorly to the femoral vein and the pectineus muscle before passing between the latter and the adductor longus muscle. On the left side, it passed above the arc of the great saphenous vein, on the right side, it passed above the junction of the superficial circumflex iliac vein into the femoral vein. The medial femoral circumflex femoral artery passing anteriorly to the femoral is an extremely rare anatomical variation. Knowledge of this variation is important for cardiovascular surgeons during endovascular interventions such as cardiac catheterization as well as for radiologists when performing Doppler ultrasound or CT angiography.