Surgical anatomy of the veins of the lower limb - a cadaveric study

Abstract

INTRODUCTION: With the advent of new surgical techniques, an adequate knowledge of precise anatomy of the venous system of the lower limb is important for safe surgery. The aim of this study is to provide some basic information for those who are interested in phlebology. MATERIALS AND METHODS: The anatomy of the superficial and deep veins of both lower limbs was studied in 20 human cadavers (age 42-72 years) of both sexes (12 males: 08 females). Great saphenous vein (GSV) and small saphenous vein (SSV) were traced from medial and lateral malleoli to the sapheno-femoral junction (SFJ) and saphenopopliteal junction (SPJ) respectively. The number of deep perforators was counted and measurements were taken from a fixed anatomical land mark. RESULTS: In both lower limbs of 17 cadavers (85%), the course of GSV was similar to the course described in the commonly used text books. Large tributary with a diameter similar to GSV at the SFJ was seen in 3 cadavers (15%). The point of entry of SSV into the popliteal vein varied greatly. In majority of cadavers the opening was at the level of the popliteal skin crease and in others it was either above or below this. Large deep perforators were found in the calf and thigh with irregularly distributed small perforators. CONCLUSION: A majority of individuals have the lower limb superficial venous pattern described in standard text books. However, a significant minority had variations, which could have important implications on the presentation and treatment of varicose