Volume 4, Issue 1, June 2018, Page: 32-39
Saphenofemoral Complex: Anatomical Variations and Clinical Significance
Ehab Mostafa Elzawawy, Anatomy and Embryology Department, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
Ayman Ahmed Khanfour, Anatomy and Embryology Department, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
Received: Jul. 13, 2018;       Accepted: Aug. 10, 2018;       Published: Sep. 5, 2018
DOI: 10.11648/j.ijcda.20180401.15      View  1062      Downloads  117
Varicosities of great saphenous vein (gsv) or its tributaries are a common medical condition present in up to 25% of adults. The gsv and its tributaries are located in a fascial compartment on the front of the thigh. There are great anatomical variations of these veins. However, the relation between these veins and the fascia lata on the front of thigh is even more variable and carries greater clinical importance. Forty cadaveric lower limbs were dissected to examine anatomical variations of these veins and describe their relation to the deep fascia of the thigh. Fascia lata of the front of the thigh split into superficial saphenous fascia and deep fascia lata proper. This fascial splitting formed the saphenous compartment. There were 3 types of saphenous compartment. Type 1 (30%), there was a triangular saphenous compartment containing the gsv and its tributaries. Type 2 (30%), there was a fascial canal containing the gsv. Type 3 (40%), there was a small fascial saphenous compartment with variable boundaries that contained the gsv and 1 or 2 of its tributaries. The number of superficial tributaries in the front of the thigh ranged from 3-7 with a mean of 5.12 ±1.95. The length of the gsv in the saphenous compartment ranged from 5-8.5 cm with a mean of 6.43±1.65 cm. The length of tributaries in the saphenous compartment ranged from 2-6 cm with a mean of 3.82±2.74cm. The external pudendal artery (epa) was intimately related to saphenofemoral junction (sfj) in 30% of cases. The cutaneous branches of the femoral nerve were related to the gsv, its tributaries and sfj in 52.5% of cases. Precise identification of the location of the gsv, its tributaries in relation to deep fascia of the thigh, epa and cutaneous nerves is crucial for planning appropriate surgical technique in case of varicosities.
Great Saphenous Vein, Superficial Tributaries, Fascia Lata, Saphenous Triangle
To cite this article
Ehab Mostafa Elzawawy, Ayman Ahmed Khanfour, Saphenofemoral Complex: Anatomical Variations and Clinical Significance, International Journal of Clinical and Developmental Anatomy. Vol. 4, No. 1, 2018, pp. 32-39. doi: 10.11648/j.ijcda.20180401.15
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Gabella G. Cardiovascular system. In Williams PL, editor. Gray’s Anatomy. 38th ed. New York: Churchill Livingstone. 1995; p 1596.
Sinnatamby CS, Last RJ. Last’s Anatomy: Regional and Applied. 10th ed. Edinburgh: Churchill Livingstone. 2000; p112.
Souroullas P, Barnes R, Smith G, Nandhra S, Carradice D, Chetter I. The classic saphenofemoral junction and its anatomical variations. Phlebology 2017; 32(3): 172–178.
Donnelly M, Tierney S and Feeley TM. Anatomical variation at the saphenofemoral junction. Br J Surg. 2005; 92: 322–325.
Williams A. Pelvic girdle and lower limb. In Standring S, editor. Gray’s Anatomy, The Anatomical Basis of Clinical Practice. 39th ed. Churchill Livingstone, Edinburgh. 2005; p 1420.
Chen SSH and Prasad SK. Long saphenous vein and its anatomical variations. AJUM 2009; 12 (1): 28–31.
Leopardi D, Hoggan BL, Fitridge RA, Woodruff PWH, Maddern GJ. Systematic review of treatments for varicose veins. Ann Vasc Surg. 2009;23:264-276.
Beale RJ, Gough MJ. Treatment options for primary varicose veins-a review. Eur J Vasc Endovasc Surg. 2005;30:83-95.
Kirkpatrick L. A, Feeney B. C. A Simple Guide to IBM SPSS Statistics for Version 20.0, Cengage Learning, Belmont, Calif, USA. 2013.
Papadopoulos NJ, Sherif MF, Albert EN. A fascial canal for the great saphenous vein: gross and microanatomical observations. J Anat.1981; 132 (3): 321–329.
Hemmati H, Baghi I, Zadeh KT, Okhovatpoor N, Nejad EK. Anatomical variations of the saphenofemoral junction in patients with varicose veins. Acta Medica Iranica. 2012; 50 (8): 552-555.
Mansberger AR, Yeagher GH, Smelser RM, Brumback FM. Saphenofemoral junction anomalies. Surg Gynecol Obstet. 1950;91:533-536.
Tavlasoglu MG, Guler A, Gubuz HA, Tanriseven M, Kurkluoglu M, Yesil FG. Anatomical variations of the saphenofemoral junction encountered during venous surgery. J Cardiovasc Surg. 2013; 1: 5–7.
Cushieri A, Steele RJC and Moossa AR. Essential surgical practice: higher surgical training in general surgery, 4th ed. London: Arnold. 2002.
Murakami G, Negishi N, Tanaka K. Anatomical relationship between saphenous vein and cutaneous nerves. Okajimas Folia Anat Jap. 1994; 71(1):21-23.
Cappelli M, Molino Lova R, Ermini S, Zamboni P. Hemodynamics of the sapheno-femoral junction. Patterns of reflux and their clinical implications. Int Angiol. 2004;23:25-8.
Dickson R, Hill G, Thomson IA, van Rij AM. The valves and tributary veins of the saphenofemoral junction: ultrasound findings in normal limbs. Veins and Lymphatics 2013; 2(18):63-67.
Fischer R, Chandler JG, De Maeseneer MG. The unresolved problem of recurrent saphenofemoral reflux. JACS 2002; 195 (1): 80–94.
Carandina S, Mari C, De Palma M, Marcellino MG, Cisno C, Legnaro A, et al. Varicose vein stripping vs haemodynamic correction (CHIVA): a long term randomised trial. Eur J Vasc Endovasc Surg. 2008;35:230-237.
Brittenden J, Cotton SC, Elders A, Ramsay CR, Norrie J, Burr J, et al. A randomized trial comparing treatments for varicose veins. New Engl J Med. 2014; 371: 1218–1227.
De Maeseneer MG, Philipsen TE, Vandenbroeck CP, Lauwers PR, Hendriks JM, De Hert SG, et al. Closure of the cribriform fascia: an efficient anatomical barrier against postoperative neovascularisation at the saphenofemoral junction? a prospective study. Eur J Vasc Endovasc Surg. 2007;34, 361-366.
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