Variations in Sapheno-Popliteal Junction Anatomy

Background: Varicose veins are also common in short saphenous vein territory which has most variable anatomy in lower extremity. Variations in the veins of the lower limb are very common. This may be due to the anomalous involvement of the main trunks of the veins or their tributaries alone. Detailed knowledge regarding the anatomical variations such as reduplication of vein and unusual course and termination of the vein is a prerequisite in the diagnosis and management of vascular diseases. Methods: Included in the study were 626 Limbs. They were referred to radiology department by physicians, surgeons, and orthopedicians for investigation of clinically detected superficial varicosities and suspected chronic venous disease. The examination includes history, clinical examination, and detailed duplex scanning of lower limb veins. Study data were based on the detailed examination and reporting of anatomic variation of termination of the short saphenous vein (SSV). Duplex scanning of lower limb veins was performed with the patient standing on low stool. Body weight was on placed on a contralateral limb which enabled examined side to be relaxed, slightly flexed, and externally rotated position. The popliteal fossa and calf venous system were evaluated with particular attention to termination of SSV. A real time B-mode zoom facility enabled optimal anatomic delineation of the SSV and Giacomini vein. The termination of SSV is variable and three patterns have been defined. Results: Following important observations was made: 410 out of 620 (65%) lower extremities shows the prevalence of Giacomini vein. In 45 out of 620 (7.2%) lower extremities, the SSV terminated into popliteal vein with further extension into thigh. In 171 out of 620 (27%) lower extremities, the SSV terminated into popliteal vein. Conclusion: A proper knowledge about the anatomy of the short saphenous vein and its communications with other veins and mode of termination of short saphenous vein is mandatory for a safe and successful intervention. The variant termination of the small saphenous vein may contribute to recurrent varicose veins in this territory; this aspect generally makes the subject of interest in the view of varicose vein operations.

Publication History

Article published online:
11 May 2021