Document Detail


The anatomy of the small saphenous vein: fascial and neural relations, saphenofemoral junction, and valves.
MedLine Citation:
PMID:  20022210     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Varicose veins are a frequent burden, also in the small saphenous system. Yet its basic anatomy is not described consistently. We therefore investigated the fascial and neural relationships of the small saphenous vein (SSV) as well as the frequency and position of valves and the different junctional patterns, also considering the thigh extension.
MATERIALS AND METHODS: We dissected the legs of 51 cadavers during the regular dissection course held in winter 2007 at Innsbruck Medical University, with a total of 86 SSVs investigable proximally and 94 SSVs distally.
RESULTS: A distinct saphenous fascia is present in 93 of 94 cases. It starts with a mean distance of 5.1 cm (SD 1.2 cm) proximal to the calcaneal tuber, where the tributaries to the SSV join to form a common trunk. The neural topography at the level of the gastrocnemius muscle's origins shows the medial sural cutaneous nerve in 88% medially and in 12% laterally to the SSV, the tibial nerve in 64% medially and in 36% laterally, and the common fibular nerve in 98% medially and in 2% laterally to the vein. The saphenopopliteal junction (SPJ) resembled in about 37% type A (UIP-classification), 15% type B, and 24% type C. A total of 17% of specimens showed a venous web or star at the popliteal fossa and 6% had a doubled junction. A thigh extension could be demonstrated in about 84%. A most proximal valve was present in only 94% at a mean distance of 1.2 cm (SD 1.4 cm) to the SSVs orifice. A consecutive distal valve was only present in 65% with a mean distance of 5.1 cm (SD 2.3 cm).
CONCLUSION: Two fascial points or regions can be described in the SSVs' course and its own saphenous fascia is demonstrated macroscopically in almost all cases. The neural topography is highly individual. The SPJ is highly individual where we found hitherto unclassified patterns in a remarkable number of veins. Venous valves are not as frequent as we supposed them to be. Furthermore, not all most proximal valves seem to be terminal valves.
Authors:
Gregor Schweighofer; Dominic Mühlberger; Erich Brenner
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  51     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-29     Completed Date:  2010-04-15     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  982-9     Citation Subset:  IM    
Affiliation:
Division of Clinical and Functional Anatomy, Department of Anatomy, Histology, and Embryology, Innsbruck Medical University, Innsbruck, Austria.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cadaver
Dissection
Fascia / anatomy & histology*
Female
Femoral Vein / anatomy & histology*
Humans
Lower Extremity / blood supply*
Male
Peroneal Nerve / anatomy & histology
Popliteal Vein / anatomy & histology
Saphenous Vein / anatomy & histology*,  innervation
Sciatic Nerve / anatomy & histology*
Sural Nerve / anatomy & histology
Tibial Nerve / anatomy & histology
Venous Valves / anatomy & histology*
Comments/Corrections
Comment In:
J Vasc Surg. 2010 Nov;52(5):1428-9; author reply 1429   [PMID:  21050996 ]

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