Aberrant course of the superficial femoral artery and profunda femoris artery: A rare vascular anomaly identified during peripheral artery disease intervention

Congenital anomalies in the branching and course of major lower extremity arteries are uncommon but may have critical implications for surgical and interventional procedures. Awareness of such variations is essential to avoid inadvertent vascular injury. We describe a 65-year-old woman undergoing peripheral angiography for management of symptomatic peripheral artery disease (PAD), in whom a rare vascular anomaly was discovered. The superficial femoral artery (SFA) originated from the common femoral artery but followed an aberrant lateral and posterior course before terminating as the popliteal artery, and the profunda femoris branches which extended medially in the thigh. The procedure was successfully completed with technical modifications. This case highlights a previously undescribed course of the SFA and emphasizes the importance of recognizing rare vascular anomalies to ensure safe planning and execution of interventions.