Peripheral Vascular Anatomy

Peripheral vascular anatomy describes the arteries and veins of the limbs and how their named segments and common variants are identified on imaging. For the lower extremity in particular, it covers the continuous arterial pathway from the abdominal aorta through the iliac and femoral arteries to the calf runoff vessels, together with the corresponding deep and superficial venous drainage, as displayed by CT and MR angiography, ultrasound, and catheter angiography.

Definition

Peripheral vascular anatomy is the descriptive and topographic anatomy of the arteries and veins of the upper and lower limbs, including their named segments, the limb arterial inflow and runoff pathway, the deep and superficial venous systems, and recognized variants as resolved on angiographic and cross-sectional imaging.

Scope

This topic covers the upper- and lower-limb arterial supply and venous drainage, the aortoiliac-femoral-popliteal-runoff arterial pathway, the deep and superficial limb venous systems, and the normal variants encountered on peripheral imaging. It treats peripheral vascular anatomy as depicted on imaging and is not a guide to diagnosing or treating peripheral vascular disease. Note: the controlled-vocabulary descriptor recorded in the source block (Peripheral Nerves) names the nervous-system structures that accompany these vessels and was assigned as the node identifier; the body of this entry concerns the peripheral blood vessels.

Core questions

• How does the arterial supply run from the aorta through the limb to the runoff vessels?
• How are the deep and superficial venous systems of the limbs organized and traced?
• Which peripheral vascular variants are common enough to expect on routine imaging?
• How do CT angiography, MR angiography, ultrasound, and catheter angiography depict limb vessels?

Key concepts

• Aortoiliac inflow segment
• Femoropopliteal segment
• Calf runoff vessels (anterior tibial, posterior tibial, peroneal arteries)
• Deep versus superficial limb venous systems
• Arterial inflow and runoff on CT angiography
• Peripheral vascular variants and accessory branches

Mechanisms

In the lower limb the arterial pathway is conventionally described in three contiguous segments: an aortoiliac inflow segment, a femoropopliteal segment, and the infrapopliteal calf runoff vessels that continue into the foot. Venous return travels through paired deep veins that accompany the arteries and a superficial venous system that drains into the deep system. On imaging, the whole pathway can be displayed volumetrically with CT or MR angiography timed to the arterial phase and reformatted along the limb, while ultrasound interrogates individual segments with flow information and catheter angiography provides selective luminal projections. Recognizing the named segments, their accompanying veins, and the common variants is the basis for tracing the peripheral circulation consistently across these modalities (rubin-2001; shetty-2025; standring-2020).

Clinical relevance

Knowing the normal limb arterial pathway and venous drainage and their variants supports accurate radiological description and procedural planning, because the segmental organization of inflow and runoff frames how peripheral studies are reported and how access and intervention routes are chosen. This entry describes how peripheral vascular anatomy is identified and named on imaging and does not provide diagnostic criteria or treatment guidance.

Evidence & guidelines

Descriptive peripheral vascular imaging anatomy rests on anatomical atlases and on imaging series and illustrated reviews that establish how the limb arterial inflow and runoff and the venous drainage are depicted and segmented on CT and MR angiography (standring-2020; rubin-2001; shetty-2025).

History

Peripheral vessels were first imaged in the living patient by catheter angiography, and the depiction of the limb circulation was transformed by multidetector CT angiography, which made it routine to display the entire lower-extremity arterial inflow and runoff in a single volumetric acquisition. This established the segmental aortoiliac, femoropopliteal, and runoff framework now used to describe peripheral vascular anatomy on cross-sectional imaging (rubin-2001; shetty-2025).

Seminal works

• rubin-2001
• shetty-2025
• standring-2020

Frequently asked questions

How is the lower-limb arterial pathway divided on imaging?

It is commonly described in three contiguous segments: the aortoiliac inflow, the femoropopliteal segment, and the infrapopliteal calf runoff vessels (the anterior tibial, posterior tibial, and peroneal arteries) continuing into the foot.

Why does the controlled-vocabulary descriptor for this entry say Peripheral Nerves?

The descriptor recorded in the source metadata names the nerves that travel alongside the limb vessels and was assigned as this node's identifier. The content of the entry itself concerns the peripheral arteries and veins, not the nerves.