Basic anatomy of the superficial venous system of the lower extremity with ultrasonographic correlation

Superficial veins of the lower extremity are topographically divided into: 1) Veins of the medial aspect of the extremity (great saphenous vein and branches). 2) Veins of the lateral aspect of the extremity. 3) Veins of the posterior aspect of the extremity (small saphenous vein and branches) and, 4) Communicating veins. Superficial veins lie above the muscular fascia, deep veins lie below the muscular fascia and perforating veins run through the muscular fascia and connect deep and superficial veins. A thinner fascial plane, the saphenous fascia, covers the saphenous trunks and separates them from their branches. B-mode ultrasonography provides real time, high resolution imaging of the veins of the lower extremity and of their variants. Pulsed-wave and color Doppler provide hemodynamic information for the diagnosis and grading of venous insufficiency. Thorough knowledge of the anatomy of superficial lower limb veins and expertise in ultrasonographic study of these veins are prerequisites for the diagnosis and interventional treatment of venous insufficiency of the lower extremity.