Small Saphenous Vein

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Description[edit | edit source]

The Small Saphenous Vein (SSV) is a superficial vein of the posterior leg. It drains the leg's lateral surface and runs up the leg's posterior surface to drain into the popliteal vein. Previously called also "lesser saphenous vein" or "short saphenous vein", the use of those terms has been discouraged and are no longer recommended for the purpose of standardizing terminology [1].

Leg veins.png

Anatomy[edit | edit source]

According to several descriptions, the small saphenous vein (SSV) has major anatomical variations due to its embryological origin [2]. The SSV enters the popliteal fossa and then drains into the popliteal vein just above the level at which the two heads of the gastrocnemius diverge, by either joining the popliteal directly or after joining a gastrocnemius vein first. The small saphenous vein possesses from nine to twelve valves, one of which is always found near its termination in the popliteal vein [3]. About one-third to one-half of the way down from the popliteal fossa to the ankle, near the inferior termination of the gastrocnemius muscles, the sural nerve enters the saphenous space and is adjacent to the SSV. These two structures become more intimately related further down the calf. The sural nerve provides sensory innervation to the posterolateral calf and lateral aspect of the foot [4].

Course[edit | edit source]

The SSV extends from the lateral margin 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 some people, 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 SSV usually gives off a branch, the vein of Giacomini, which extends up the thigh and runs between the biceps femoris and semimembranosus muscles [5].

Small Saphenous Vein.jpg

Function[edit | edit source]

The small saphenous vein's primary function is to receive deoxygenated blood from the lower legs and return it to the heart. The blood from the small saphenous vein typically drains into the popliteal vein located around the knee [6].


Clinical Significance[edit | edit source]

There are conditions that can be associated with the Small Saphenous Vein:

  • Varicose Veins.
  • Venous Reflux Disease or Venous Insufficiency.
  • Formation of blood clots leading to Thrombophlebitis that can cause pain and inflammation of the extremities.

The Small saphenous vein (SSV) reflux is an important and often overlooked cause of superficial venous insufficiency. It is present in about one-sixth of patients with superficial venous insufficiency, and its manifestations are often confused with reflux in the great saphenous vein (GSV) [4].

Different treatments are prescribed depending not only on the signs and symptoms but also on the condition's severity. When venous insufficiency becomes a chronic problem, the saphenous vein can be shut down via endovenous ablation or removed with traditional vein stripping. This can also be performed for cosmetic reasons [6]. Clinically, the knowledge of the SSV variations is useful during coronary artery bypass grafts as it is increasingly being used as the grafted vein. Therefore, it's necessary for plastic surgeons to know the variant course and termination of the small saphenous vein [7].


[8]


References[edit | edit source]

  1. Lee DK, Ahn KS, Kang CH, Cho SB. Ultrasonography of the lower extremity veins: anatomy and basic approach. Ultrasonography. 2017 Apr; 36(2):120. 
  2. Rossi GG, Belczak CE, Rossi C. Small saphenous vein: where does reflux go? Jornal Vascular Brasileiro. 2013 Jun; 12(2):123-8.
  3. Small saphenous vein; Short saphenous vein - Vena saphena parva. Available from: https://www.imaios.com/en/e-Anatomy/Anatomical-Parts/Small-saphenous-vein-Short-saphenous-vein (Accessed, 20/03/2021)
  4. 4.0 4.1 Elias ST, Khilnani NE. Treating the small saphenous vein. Endovasc Today. 2008;7(8):60-4. 
  5. Small saphenous vein. Available from: https://www.kenhub.com/en/library/anatomy/small-saphenous-vein (Accessed, 20/03/21)
  6. 6.0 6.1 The Anatomy of the Small Saphenous Vein located in the Lower Leg. Available from: https://www.verywellhealth.com/small-saphenous-vein-5113216 (Accessed, 02/04/2021)
  7. Shetty P, D’Souza MR, Nayak SB. An unusual course and termination of Small saphenous vein: a case report. Journal of clinical and diagnostic research: JCDR. 2016 Mar; 10(3): AD01. 
  8. Anatomy Knowledge. Great Saphenous Vein & Small Saphenous Vein - Venous drainage of lower limb. Available from: http://www. https://www.youtube.com/watch?v=jZ-U-2v9X6U[last accessed 4/4/2021]