A thorough understanding of the venous anatomy in the lower extremities is of the utmost importance to the vein specialist. This includes both superficial and deep venous systems
The deep venous system begins in the plantar veins draining into tibial veins. There are anterior, posterior and peroneal veins. These veins connect to form the popliteal vein a the upper calf. The gastrocneimius veins also join to form the popliteal vein. At the distal thigh, the popliteal vein becomes the femoral vein which ultimately joins with the deep femoral vein at the groin to become the common femoral vein.
The most recognized components of the superficial venous systems are the great saphenous vein (GSV) and small saphenous vein (SSV). The saphenous veins runs within the saphenous sheaths that is deep to the superficial fascia, but superficial the muscular fascia. They are referred also then as interfascial veins and are often the causative factors for vein disease. These veins are the targets for treatment including radiofrequency ablation and foam sclerotherapy.
The superficial venous system is composed of the collecting veins that are subcutaneous, truncal veins (great saphenous and small saphenous veins) and their tributaries.
The GSV begins on the dorsum of the foot and ascends medially along the calf and thigh to join the common femoral vein at the sapheno-femoral junction in most instances. There are thigh and calf tributaries known as circumflex veins. At the junction, three important tributaries drain directly into the GSV and serve as landmarks for treatment during endovenous ablation to cure varicose veins in the legs.
The SSV begins on the lateral aspect of the foot and passes behind the lateral malleolus ascending up the calf. The terminatinon generally occurs at the popliteal crease directly into the popliteal vein, though variations include more cephalad terminations into the deep veins via perforators or continue up into thigh extensions, such as the vein of Giacomini.
The varicose vein doctor near me should be aware of important relations between the truncal veins and nearby superficial nerves. These can be damaged during endovenous ablation or ambulatory phlebectomy during treatment of varicose veins without proper care.