The cruciate anastomosis is an arterial network located on the posterior surface of the proximal femur. Some authors refer to it as the collateral circulation at the hip joint. The cruciate anastomosis is formed by the:
- First perforating branch of deep femoral artery
- Inferior gluteal artery
- Lateral circumflex femoral artery
- Medial circumflex femoral artery
The function of the cruciate anastomosis is to provide an alternative route for the blood supply of the lower limb when there is a blockage of the blood flow between the external iliac and femoral arteries. The cruciate anastomosis is often confused with the trochanteric anastomosis. However, the latter is a network between the superior gluteal artery and medial/lateral circumflex femoral arteries. But essentially, its function is the same as that of the cruciate anastomosis; it provides the collateral blood flow to support the femoral head.
|Origin||Deep femoral, inferior gluteal, lateral circumflex femoral, medial circumflex femoral arteries|
|Supply and function||Alternative route for the blood supply of the lower limb in case of femoral artery obstruction|
This article will discuss the anatomy and function of the cruciate anastomosis.
Origin and location
The cruciate anastomosis is found at the level of the lesser trochanter, just below the femoral attachment of the quadratus femoris muscle. It resembles a cross, which is why it is called like this (lat. crux means cross).
The anastomosis is formed by the four vessels:
- Ascending branch of the first perforating artery (of deep femoral artery), which joins the anastomosis from below
- Descending branch of the inferior gluteal artery, which joins the anastomosis from above
- Transverse branch of the lateral circumflex femoral artery, which joins the anastomosis from the lateral side
- Transverse branch of the medial circumflex femoral artery, which joins the anastomosis from the medial side
A handy mnemonic for remembering the participating vessels is “FILM” (First perforating, Inferior gluteal, Lateral circumflex femoral, Medial circumflex femoral).
The function of the cruciate anastomosis is to provide the collateral arterial circulation when the communication between the femoral artery and its parent vessel, the external iliac artery, is blocked. If it wasn’t for the cruciate anastomosis, the blood supply to the whole lower limb below the site of blockage would be compromised.
In these cases, the internal iliac artery becomes the main source of the arterial blood for the lower limb, which it delivers via the cruciate anastomosis in the following way;
- The internal iliac artery gives off the inferior gluteal artery, which contributes to forming of the cruciate anastomosis
- Via cruciate anastomosis, the arterial blood reaches the first perforating branch of the deep femoral artery and the lateral circumflex femoral artery
- The arterial blood then flows through the descending branch of the lateral femoral circumflex artery, via which it reaches the superior lateral genicular artery
- Lastly, from here, the blood flows into the popliteal artery; the chief parent vessel for the blood supply of the leg and foot
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