Abstract
Varicose vein repair often necessitates a distal approach to the great saphenous vein (GSV). The classic method involves a medial pre-malleolar approach. We propose a more distal approach via the medial surface of the foot where there is a cutaneous landmark, which can be used to locate the GSV in a simple, reliable and reproducible fashion. In 20 cadaveric feet, we dissected out the GSV exploiting the above-mentioned cutaneous landmark. We then extended the dissection up as far as the medial pre-malleolar region (from where the GSV is classically approached) in order to be able to compare the diameter of the vein at the two different points (in the foot and in the pre-malleolar region). We also compared the cutaneous landmark with ultrasonographic location of the GSV in 22 feet of healthy subjects. Both dissections and ultrasound examinations demonstrated the reliability of the cutaneous landmark. Moreover, no significant difference was detected in the diameter of the GSV at the two different approach points. This original distal approach to the GSV requires only minor modifications of current practice for varicose veins surgical treatment.
Similar content being viewed by others
References
Branchereau PMA, E Rosset (1995) Veines du membre inférieur. In: Voies d’abord des vaisseaux. Arnette Blackwell, Paris, pp 311–321
Caggiati ABJ (2002) The saphenous vein: derivation of its name and its relevant anatomy. J Vasc Surg 35:172–175
Caggiati ABJ, Gloviczki P, Eklof B, Allegra C, Partsch H, An International Interdisciplinary Consensus Committee on Venous Anatomical Terminology (2005) Nomenclature of the veins of the lower limb: extensions, refinements, and clinical application. J Vasc Surg 41:719–724
Creton D (1996) Eveinage Conventionnel: techniques, Complication, Résultats. In: Chirurgie des veines des membres inférieurs. AERCV Edition, Paris, pp 125–143
Bonnel F, Outrequin G (1991) Les nerfs de la cuisse et du genou. In: Anatomie Clinique, Les membres. Springer-Verlag, Paris, pp 443–446
Gerbault O (1989) Chirurgie plastique reconstructrice et esthétique. In: Encyclopédie Médico-Chirurgicale Techniques chirurgicales. Editions Techniques, Paris, pp 1–9
Dubois JLJP (1966) In: Maloine (ed) Anatomie descriptive du pied humain. Maloine, Paris, pp 367–368
Kahle WLH, Platzer W (1989) Vaisseaux périphériques. In: Anatomie Tome 2 Viscères. Flammarion Medecine-Sciences, Paris, pp 76–77
Perrin M (1995) Chirurgie de l’insuffisance veineuse superficielle. In: Encyclopédie Médico-Chirurgicale. Techniques Chirurgicales. Chirurgie vasculaire. Editions Techniques, Paris, pp 43–61
Ricci SCA (1999) Does a double long saphenous vein exists? Phlebology 14:59–64
Rouvière H (1976) In: Précis d’anatomie et de dissection. Masson, Paris, pp 835–837
Acknowledgements
Special thanks to Dr. Peyman Benharash from the University of Stanford, USA, for language editing.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Picquet, J., Coiffard, C., Pechard, M. et al. Anatomical basis of an original pedal approach to the great saphenous vein for surgery. Surg Radiol Anat 28, 176–179 (2006). https://doi.org/10.1007/s00276-005-0057-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00276-005-0057-9