Small saphenous vein
The small (short or lesser) saphenous vein is a superficial vein of the leg. It drains the lateral surface of the leg, and runs up the posterior surface of the leg to drain into the popliteal vein. In this article we will discuss the anatomy and clinical relevance of the small saphenous vein.
The dorsal venous arch of the foot connects the great saphenous vein, that drains the medial surface of the leg and thigh into the femoral vein at the saphenofemoral junction, to the small saphenous vein, which is a superficial vein.
The small saphenous vein extends from the lateral marginal of the foot posterior to the lateral malleolus. It then ascends along the posterior surface of the leg and passes between the two heads of gastrocnemius. In many individuals, the small saphenous vein drains into the popliteal vein at the saphenopopliteal junction, whose location is variable but proximal to the tibial plateau in most cases. The small saphenous vein usually gives off a branch, the vein of Giacomini, which extends up the thigh and runs between the biceps femoris and semimembranosus muscles.
The small saphenous vein is accompanied by the sural nerve along its course in the posterior aspect of the leg. The sural nerve is a sensory cutaneous nerve that is formed by branches from the common fibular (ventral rami of L4-S2) and tibial (ventral rami of L4-S3) branches of the sciatic nerve (ventral rami of L4-S3).
Varicose veins: The small saphenous vein is a superficial vein. The deep veins (posterior tibial, anterior tibial, fibular, popliteal, femoral) are separated from the superficial veins by a series of valves. These valves ensure blood flows from the superficial system to the deep system and prevent backflow. Incompetence of these valves results in tortuous veins, called varicose veins. Signs associated with such veins include:
- pain, if chronic
- brown discoloration of the distal leg, resulting in champagne bottle shaped legs
Varicose vein removal: If the presence of varicose veins is causing problems, endovenous thermal ablation of the veins can be performed. This procedure is sometimes associated with complications due to the proximity of adjacent structures such as the sural nerve. Possible indications include:
- venous ulcers
- skin changes
- cosmetic reasons