Small saphenous vein

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Small saphenous vein
Gray582.png
Small saphenous vein and its tributaries. (Small saphenous vein labeled vertically at center.)
Details
Source dorsal venous arch of the foot
Drains to popliteal vein
Identifiers
Latin vena saphena parva
TA98 A12.3.11.010
TA2 5085
FMA 44333
Anatomical terminology

The small saphenous vein (also short saphenous vein or lesser saphenous vein) is a relatively large superficial vein of the posterior leg.

Contents

Structure

The origin of the small saphenous vein, (SSV) is where the dorsal vein from the fifth digit (smallest toe) merges with the dorsal venous arch of the foot, which attaches to the great saphenous vein (GSV). It is a superficial vein, being subcutaneous (just under the skin).

From its origin, it courses around the lateral aspect of the foot (inferior and posterior to the lateral malleolus) and runs along the posterior aspect of the leg (with the sural nerve), where it passes between the heads of the gastrocnemius muscle. [1] [2] This vein presents a number of different draining points. [1] Usually, it drains into the popliteal vein, at or above the level of the knee joint. [1]

Variation

Sometimes, the SSV joins the common gastrocnemius vein before draining in the popliteal vein. [2]

Sometimes, it does not make contact with the popliteal vein, but goes up to drain in the GSV at a variable level. [1]

Instead of draining in the popliteal vein, it can merge with the Giacomini vein and drain in the GSV at the superior 1/3 of the thigh. [1] [3]

Clinical significance

Varicose veins

The small saphenous vein may become varicose. [4] In 20% of cases, this is associated with chronic venous insufficiency. [5] Vein stripping is an effective treatment. [4]

Vein Harvesting

The small saphenous vein may be harvested for transplant to elsewhere in the body, such as in coronary artery bypass surgery. [6] Endoscopic vein harvesting can be used to extract the vein from the leg minimally invasively. [6]

See also

Additional images

Related Research Articles

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<span class="mw-page-title-main">Vein</span> Blood vessels that carry blood towards the heart

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<span class="mw-page-title-main">Subclavian vein</span> Blood vessel that drains the arm

The subclavian vein is a paired large vein, one on either side of the body, that is responsible for draining blood from the upper extremities, allowing this blood to return to the heart. The left subclavian vein plays a key role in the absorption of lipids, by allowing products that have been carried by lymph in the thoracic duct to enter the bloodstream. The diameter of the subclavian veins is approximately 1–2 cm, depending on the individual.

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<span class="mw-page-title-main">Perforator vein</span>

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<span class="mw-page-title-main">Ultrasonography of chronic venous insufficiency of the legs</span> Non-invasive medical procedure

Ultrasonography of suspected or previously confirmed chronic venous insufficiency of leg veins is a risk-free, non-invasive procedure. It gives information about the anatomy, physiology and pathology of mainly superficial veins. As with heart ultrasound (echocardiography) studies, venous ultrasonography requires an understanding of hemodynamics in order to give useful examination reports. In chronic venous insufficiency, sonographic examination is of most benefit; in confirming varicose disease, making an assessment of the hemodynamics, and charting the progression of the disease and its response to treatment. It has become the reference standard for examining the condition and hemodynamics of the lower limb veins. Particular veins of the deep venous system (DVS), and the superficial venous system (SVS) are looked at. The great saphenous vein (GSV), and the small saphenous vein (SSV) are superficial veins which drain into respectively, the common femoral vein and the popliteal vein. These veins are deep veins. Perforator veins drain superficial veins into the deep veins. Three anatomic compartments are described, (N1) containing the deep veins, (N2) containing the perforator veins, and (N3) containing the superficial veins, known as the saphenous compartment. This compartmentalisation makes it easier for the examiner to systematize and map. The GSV can be located in the saphenous compartment where together with the Giacomini vein and the accessory saphenous vein (ASV) an image resembling an eye, known as the 'eye sign' can be seen. The ASV which is often responsible for varicose veins, can be located at the 'alignment sign', where it is seen to align with the femoral vessels.

<span class="mw-page-title-main">Giacomini vein</span>

The Giacomini vein, or cranial extension of the small saphenous vein is a communicating vein between the great saphenous vein (GSV) and the small saphenous vein (SSV). It is named after the Italian anatomist Carlo Giacomini (1840–1898). The Giacomini vein courses the posterior thigh as either a trunk projection, or tributary of the SSV. In one study it was found in over two-thirds of limbs. Another study in India found the vein to be present in 92% of those examined. It is located under the superficial fascia and its insufficiency seemed of little importance in the majority of patients with varicose disease, but the use of ultrasonography has highlighted a new significance of this vein. It can be part of a draining variant of the SSV which continues on to reach the GSV at the proximal third of the thigh instead of draining into the popliteal vein. The direction of its flow is usually anterograde but it can be retrograde when this vein acts as a bypass from an insufficient GSV to SSV to call on this last one to collaborate in draining. Many discussions exist about this vein, some of them confusing to a non-expert reader. Insufficiency in the Giacomini vein can present in isolation but is mostly seen together with a GSV insufficiency. It has been shown to be effectively treated either with endovenous laser ablation or by ultrasound guided sclerotherapy.

The sapheno-femoral junction (SFJ) is located at the saphenous opening within the groin and formed by the meeting of the great saphenous vein (GSV), common femoral vein and the superficial inguinal veins. It is one of the distinctive points where a superficial vein meets a deep vein and at which incompetent valves may occur.

References

  1. 1 2 3 4 5 Ricci, Stefano (2017-01-01), Goldman, Mitchel P.; Weiss, Robert A. (eds.), "1 - Anatomy", Sclerotherapy (Sixth Edition), Elsevier, pp. 1–26, doi:10.1016/b978-0-323-37726-3.00001-0, ISBN   978-0-323-37726-3 , retrieved 2020-11-19
  2. 1 2 Myers, KENNETH; Clough, AMY (2007-01-01), Bergan, John J. (ed.), "CHAPTER 32 - Treatment of Small Saphenous Vein Reflux", The Vein Book, Burlington: Academic Press, pp. 291–298, doi:10.1016/b978-012369515-4/50035-1, ISBN   978-0-12-369515-4 , retrieved 2020-11-19
  3. "VEINSURG - Duplex Ultrasound Investigation of the Veins in Chronic Venous Disease of the Lower Limbs-UIP Consensus Document. Part II. Anatomy". Archived from the original on 2013-06-26. Retrieved 2013-02-10.
  4. 1 2 Kalra, Manju; Gloviczki, Peter (2009-01-01), Hallett, John W.; Mills, Joseph L.; Earnshaw, Jonothan J.; Reekers, Jim A. (eds.), "chapter 44 - Surgical Treatment of Varicose Veins", Comprehensive Vascular and Endovascular Surgery (Second Edition), Philadelphia: Mosby, pp. 756–770, doi:10.1016/b978-0-323-05726-4.00046-9, ISBN   978-0-323-05726-4 , retrieved 2020-11-25
  5. Goldman, Mitchel P.; Guex, Jean-Jérôme (2017-01-01), Goldman, Mitchel P.; Weiss, Robert A. (eds.), "11 - Intravascular Approaches to the Treatment of Varicose Veins: Radiofrequency, Lasers and More", Sclerotherapy (Sixth Edition), Elsevier, pp. 347–364, doi:10.1016/b978-0-323-37726-3.00011-3, ISBN   978-0-323-37726-3 , retrieved 2020-11-25
  6. 1 2 Jimenez, Juan Carlos; Smith, Joshua C. (2011-01-01), Moore, Wesley S.; Ahn, Samuel S. (eds.), "Chapter 72 - Endoscopic Vein Harvest", Endovascular Surgery (Fourth Edition), Philadelphia: W.B. Saunders, pp. 745–750, doi:10.1016/b978-1-4160-6208-0.10072-2, ISBN   978-1-4160-6208-0 , retrieved 2020-11-25