Anatomical Relationship between Saphenous Vein and Cutaneous Nerves

The anatomical relationship between the saphenous veins and cutaneous nerves was investigated in 148 lower limbs of 74 cadavers in order to re-examine the stripping technique for treatment of varicose veins. The great saphenous vein frequently ran intimately along the saphenous nerve (59.5% in the middle third and 83.1% in the lower third of the leg) in the leg region. More than half of the latter cases showed an adhesive relationship in which the perineurium of the saphenous nerve was seen histologically to be attached to the adventitia of the vein. Moreover, in the thigh region as well, the great saphenous vein had an intimate relationship with the cutaneous nerves of various origin. In contrast, the small saphenous vein was often located close to the cutaneous nerves of the calf like the sural nerve. However, the adhesive relation between the small saphenous vein and nerves was rarely observed, in contrast to the case of the great saphenous vein. From these results, the anatomical relationship between the superficial vein and nerve in the lower limb were characterized according to each part of the lower limb. Based on our observations, limited extraction of the vein was recommended to reduce the risk of nerve injury during the stripping operation.