It is the longest vein in the body and runs superficially along the length of the lower limb. 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. Varicose veins are a frequent burden, also in the small saphenous system. The anatomical nomenclature used through out the book follows international convention. Figure 4 the saphenous compartments along the limb with the great saphenous vein 1 anterior accessory of the great saphenous vein aagsv 2 and the small saphenous vein 3.
This article will discuss the anatomy of this structure followed by any relevant clinical notes on the topic. The saphenous opening is an oval aperture located in the fascia lata to allow the passage of the great saphenous vein. The great saphenous vein originates from the union of the dorsal vein of the great toe and dorsal venous network of the foot, more precisely, from the medial marginal vein. To define surgical anatomy, a prospective study of the greater saphenous venous system in 385 instances in 331. Veins of the lower limb, demonstrating the veins of the dorsal venous arch of the foot and the great saphenous vein from drake l, vogl aw, mitchell awm, tibbitts rm, richardson pe. Saphenous vein article about saphenous vein by the free. Since its initial publication nearly a decade ago, the vein book continues to serves as the ultimate comprehensive resource on venous disease. Saphenous vein venous sinus great saphenous vein popliteal vein superficial vein. Great saphenous vein and lesser saphenous vein anatomy. The great saphenous vein also known as long saphenous vein, latin. The saphenous trunks are the great saphenous vein gsv latin. Venous anatomy is very variable in some regions but is more consist ent in other parts. Pdf anatomy and embryology of the small saphenous vein. Anatomic reference books include the distal saphenous nerve, though there is a discrepancy between commonly used textbooks and the course of the saphenous nerve at the level of the ankle.
It is a superficial vein being subcutaneous, just under the skin. The great saphenous vein is the preferred term over other variants such as long saphenous vein lsv, greater saphenous vein or internal saphenous vein 5. The great saphenous vein lies within the subcutaneous tissues of the leg in the thigh in the saphenous compartment, which is bounded posteriorly by the deep. Anatomy the saphenous nerve is the longest branch of the femoral nerve. Mar 19, 2020 there are three modifications of the fascia lata, one of which is the saphenous opening. To avoid saphenous nerve injury, incisions should stay distal to the medial malleolus. Fully updated from the previous edition to include recent discoveries in the field, technological advances, and new venous procedures. No significant differences in saphenous vein anatomy were noted in these subgroups.
Great saphenous vein animated gross anatomy of lower. Most of them are segmental and localized around the knee. Hadzics textbook of regional anesthesia and acute pain management, 2e hadzic a. Our knowledge of the anatomy of lower extremity veins is based on. Low incidence saphenous vein was reported in previous literatures. Saphenous veins great or small saphenous veins treatment of the great or small saphenous veins by surgery ligation and stripping, or endovenous radiofrequency or laser ablation, microfoam sclerotherapy or cyanoacrylate adhesive may be considered medically necessary for symptomatic varicose veins venous insufficiency when the following. Bergan, jj 2007, the vein book, chapter 35, pp 315321, canada, elsevier inc. A good understanding of the venous anatomy is very important for sonographers. The great saphenous vein is also known as long saphenous vein. Great saphenous vein originates in medial foot as part of dorsal venous arch.
A cadaveric study article pdf available in folia morphologica 711. Apr 15, 2020 in this article we will discuss the anatomy and clinical relevance of the great saphenous vein. The great saphenous vein gsv is probably the commonest sick vessel of man. If the saphenous vein is removed, how is the body able to circulate blood. Anatomy lectures by dr deepak agarmor in this video you will learn anatomy of great saphenous vein. Arteries are thick walled tubular structures that carry blood pumped under high pressure from the. The chapter talks about the clinical importance of the superficial veins, especially the branches of the lateral saphenous vein. The average age was 67 years range, 34 to 98 years. Please notice the thickness of the superficial fascia layer at the upper calf. Content of lecture is from text book of anatomy from dr vishram singh great saphenous vein the great saphenous vein gsv forms part of.
For individuals who have varicose veinsvenous insufficiency and saphenous vein reflux who receive mechano. Note the deep vein femoral vein, arrows, superficial vein great saphenous vein, open arrows, and perforating vein femoral canal perforator. Nearing the knee, the vein runs in the midline between the heads of the gastrocnemius muscle and through the popliteal fossa. The great saphenous vein is a large superficial vein of the lower limb. Ultrasoundguided saphenous subsartoriusadductor canal. Mcneill, md facs capitol vein and laser center bethesda, maryland 3. Nayak 3 1 professor, department of anatomy, melaka manipal medical college manipal campus, manipal university, karnataka, india. In this article we will discuss the anatomy and clinical relevance of the great saphenous vein. Upholding its reputation as the goto reference for complete, authoritative, and uptodate information about venous function and dysfunction, this second edition effectively bridges the gap between clinical medicine and basic science, suitable both for. The term great saphenous vein vena saphena magna abbreviated as gsv.
There is one vein per kidney, that divides into 4 divisions upon entering the kidney. The great saphenous vein is the longest vein of the body and represents the preaxial vein of the lower limb. Duplex ultrasound investigation of the veins in chronic. The anatomy of the greater saphenous venous system journal of. The great saphenous vein gsv, alternately long saphenous vein. Apr 14, 2015 the accessory saphenous vein is linked to the greater saphenous vein, which runs parallel to it, and is located in the leg and thigh. The anatomy of the greater saphenous venous system. Great saphenous vein lies on anterior part of medial malleolus then.
It arises from the dorsal venous arch at the top dorsum of the. Saphenous vein definition of saphenous vein by the free. We report a case of a 22yearold male who underwent surgery for pain and heaviness of the right calf. Pdf longsegment hypoplasia of great saphenous vein with. The small saphenous vein forms by the confluence of the lateral aspect of the dorsal venous network of the foot lateral marginal vein of the foot. Anatomy of the sural nerve related to calcaneal tendon. Apr 06, 2015 the great saphenous vein is a large venous blood vessel running near the inside surface of the leg from the ankle to the groin. The great saphenous vein is located in the superficial fascia and is easily observed greek saphenous easily viewed.
After that, deoxygenated blood goes through the saphenous to the heart and lungs to get fresh oxygen and circulate it through arteries. The great saphenous vein gsv is the most common source of superficial venous reflux occurring in up to 70% of patients presenting with symptomatic varicose veins and venous. Treatment of accessory and non saphenous veins jose i. It may bifurcate, with 1 limb ending in the great saphenous vein and other in the popliteal vein. Long saphenous vein and its anatomical variations ncbi. Mar 11, 2020 at, we take user experience very seriously and thus always strive to improve. From the division of clinical and functional anatomy, department of. Classical anatomy of the long saphenous vein clinical anatomy surgical anatomy phlebographic anatomy ultrasonographic anatomy. Essential operative techniques and anatomy 4th edition pdf with you, here are a few important details regarding this book which you might be interested.
Unilateral duplication of great saphenous vein in the leg. The hind limb guide to ruminant anatomy wiley online. Yet its basic anatomy is not described consistently. Saphenous veinsparing strategies in chronic venous disease. The great saphenous vein is the longest vein in the body that originates near medial malleolus and goes up to the level of groin skin crease. They rarely extend to the inguinal area, yet in case of this, the anterior accessory saphenous vein aasv is the most common connecting vein. There is some interconnection with deep veins and with the great saphenous. For individuals who have varicose veins venous insufficiency and saphenous vein reflux who receive mechano. Small saphenous vein definition of small saphenous vein by. Sural nerve sn courses from the posterior aspect of leg to the lateral side of ankle and foot. The middleposterior branch does not cross the saphenous vein. The duplication of the great saphenous vein in the left leg was associated with oedematous leg and foot. You may not embed one of our images on your web page without a link back to our site. Incidence of duplication of great saphenous vein in the thigh.
In the uk alone 60,000 lower limb varicose vein operations are. In addition, it was pointed out that, in many limbs, the ssv is not short,6 nor is it lesser. Anatomy laboratory coordinator, auburn university, auburn, al, usa. The great saphenous vein is a large, subcutaneous, superficial vein of the leg. The lateral border of the femoral triangle is formed by the medial border of sartorius, the medial border of the femoral triangle is formed by the medial border of adductor longus and the inguinal ligament forms. Single calf trunk 45% anterior 41% posterior 4% double trunks 46% multiple 4% other 5% 100% 385 no.
Great saphenous vein path of the gsv key branches supporting structures relationship to nerves vein valve function pathophysiology anatomy impacting treatment 4. Jan 05, 2017 anatomy lectures by dr deepak agarmor in this video you will learn anatomy of great saphenous vein. Leg venous anatomy and physiology interesting perspectives john waites. The vein book is a comprehensive reference on veins and venous circulation. Duplicated great saphenous vein gsv is very rare in its course, tributaries and termination. As a general rule, the deep veins accompany and share the name of the major arteries in the lower limb. The greater saphenous vein is a large superficial near the.
Small veins give deoxigenated blood to the main saphenous vein. Anatomic variations of the saphenous vein in the calf. If the saphenous vein is removed, how is the body able to. Pdf the long saphenous vein compartment researchgate. The right umbilical vein regresses completely, the left drains the placenta.
Anatomy and embryology of the small saphenous vein. Vein anatomy and physiology function in order to understand and appreciate the anatomy of the venous system, it is sometimes good to contrast this by gaining insight into the arterial system. 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. View enhanced pdf access article on wiley online library html view. Sep 29, 2019 saphenous not comparable relating to, or situated near, the saphenous vein. The calf muscles provide most of the pump function. Duplication of great saphenous vein in the left leg of 62 yearold male cadaver was observed during routine dissection of the lower limb at the department of human anatomy, universiti putra malaysia. The great saphenous vein is a large venous blood vessel running near the inside surface of the leg from the ankle to the groin. The course of the great saphenous vein is drawn on the inner side of the leg. In one volume it provides complete, authoritative, and uptodate information about venous function and dysfunction, bridging the gap between clinical medicine and basic science. If you would like a large, unwatermarked image for your web page or blog, please purchase the appropriate license. A case report prakashchandra shetty, 1 melanie rose dsouza, 2 and satheesha b. Aug 08, 2018 just before piercing the popliteal fascia, it may generate a communicating branch to the accessory saphenous vein. For treatment of saphenous tributaries at the same time or following treatment of the saphenous vein, stab avulsion, hook phlebectomy, sclerotherapy, or transilluminated powered phlebectomy improve outcomes.
When the origin of the word saphenous is discussed, it is said that saphenous derives from the greek word safaina, the feminine form of the adjective safes, which means evident. To define the relationship between the long saphenous vein. Phlebologia atlas of anatomy of the superficial veins of the lower limbs. Saphenous nerve injury, most often noted as a painful neuroma, can contribute to significant procedurerelated morbidity. Philadelphia, churchill livingstone elsevier, 2008 29. Small saphenous vein is the preferred terminology over other terms such as short saphenous vein, external saphenous vein or lesser saphenous vein 5. It drains into the femoral vein, which is the medial most structure in the femoral triangle. The calibre of duplicated great saphenous vein almost similar to main great saphenous vein, whereas, accessory saphenous vein is smaller in size. Treatment of accessory saphenous veins by surgery, endovenous thermal ablation radiofrequency or laser. The small saphenous vein extends up the back of the lower leg to terminate usually in the popliteal vein. Also superficial inguinal lymphatics passing deeply to join deep inguinal lymphatics which then enter into abdomen via femoral canal. The green hatching shows the width of the saphenous compartment starting on the dorsal foot.
Ideally, with a better understanding of anatomy, such potential complications could be avoided. In basic practise, this vein forms from the dorsal venous arch at the dorsum of foot and later empties into the femoral vein after traverses the saphenous. Endovenous saphenous vein obliteration in the form of radiofrequency or laser therapies has quickly ascended to a position of prime importance in the treatment of reflux within the superficial venous system. Phlebologia atlas of anatomy of the superficial veins of. Saphenous vein graft pathology in saphenous vein bypass grafts in a patient with type iv hyperlipoproteinemia who had undergone coronary artery bypass surgery 4 years before death ac. Pdf anatomy of the great saphenous vein and its clinical. Ultrasonographic anatomy of the lower extremity superficial veins. The great saphenous vein gsv is also known as long or internal vein 1 is a superficial large venous vessel which runs near the inner surface of the leg from the ankle to the thigh. The deep venous drainage system of the lower limb is located beneath the deep fascia of the lower limb. Clinical anatomy of the venous system of the lower extremity. The fascial compartment of the great saphenous vein.
An unusual course and termination of small saphenous vein. Sometimes, it stops below the knee and ends in the great saphenous vein or in the deep muscular veins of the leg. Hadzics peripheral nerve blocks and anatomy for ultrasoundguided regional anesthesia, 2e hadzic a. Aplasia or hypoplasia of great saphenous vein gsv is relatively common. Anatomy femoral vein great saphenous vein small saphenous vein normal vein valves ensure blood flows in one direction diseased vein valves that cannot. C h a p t e r 2 venous embryology and anatomy geza mozes and peter gloviczki tines. Dr peter paraskevas main physiological functions return of venous blood back to the heart thermoregulation storage of blood 70% of blood stored in the venous system regulation of cardiac output thermoregulation vasoconstrictor fibres supply the svs heat response. Muscle contraction squeezes the deep veins to propel the venous blood toward the heart. Great saphenous vein and small saphenous veins are veins of the lower limb. Treat superficial venous reflux disease treatment aims to reduce or stop the backward flow of blood.
The musthave resource on the condition and treatment of varicose veins, spider veins, and thread veins. All saphenous veins in the same leg meeting criteria for treatment be treated in the same session or have documentation submitted why that should not be done there is demonstrated saphenous reflux and ceap clinical, etiology, anatomy. The short saphenous vein ascends the lateral side of the posterior leg the calf. Great saphenous vein definition of great saphenous vein by. Anatomy of the sural nerve related to calcaneal tendon, intermalleolar line and small saphenous vein. It is the longest vein in the body, running along the length of the lower limb, returning blood from the foot, leg and thigh to the deep femoral vein at the femoral triangle. Incidence of duplication of great saphenous vein in the thigh and its clinical significance a case report introduction the great saphenous vein gsv commences at the medial end of the dorsal venous arch, and after receiving branches from the sole, which join it by turning over the medial border of. Pdf veins arise from capillaries and transport blood away from the tissues towards the heart.
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