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Venous Anatomy



Endovenous laser ablation offers a clinically proven treatment for varicose veins, as a 'walk in - walk out' procedure under local anaesthetic, with the patient back on their feet in under one hour and very little patient discomfort or complications. .

It is one of a range of procedures available to treat your varicose vein and, in order for your clinician to provide the best possible treatment option to each varicose veins presentation, it is important to understand the anatomy of the venous system and its relationship to your particular venous condition.

Only by understanding the anatomy of venous system and the location at which the reflux originates can the treatment plan be optimised for each individual patient.


Venous Anatomy:

For simplification, the venous anatomy of the lower limbs can be subdivided into three main groups of veins. These are the Deep Veins, the Superficial Veins and the Perforator veins. Reflux, or ‘Venous Insufficiency’ as it is often referred to, can occur in any of these systems.

Veins of the legDeep veins:

The deep veins are the main system of veins in the leg that drain blood back to the heart. They are responsible for the majority, 90-95%, of the blood return from the lower limbs to the heart.

By name, the deep veins in the lower limbs consist of the Common Iliac, the External Iliac, the Common Femoral, the Superficial Femoral, the Deep Femoral, the Popliteal, the Posterior Tibial, the Anterior Tibial, the Peroneal and the Gastrocnemius deep veins.

The deep veins are found within the muscle fascia, which facilitates the movement of blood back to the heart. Movement of the muscle provides a pumping pressure to the veins, as a result of compression of the venous walls.

Varicose veins are not a consequence of deep venous insufficiency. One significant problem with the deep veins can be ‘Deep Vein Thrombosis,’ which is a life threatening blood clot within the deep veins that carries the risk of a pulmonary embolism.

Superficial veins:

The superficial veins are the secondary system that drains the blood from the superficial tissues and skin, through the Perforators and connections with the deep system, back into the deep veins for return back to the heart. The superficial veins their name suggests are located above the deep muscle fascia and account for 5-10% of blood return back to the heart.

By name, the superficial veins mainly consist of the Great Saphenous Vein, the Anterior Lateral Thigh Veins, the Medial Thigh Vein, the Small Saphenous Vein and the Giacomeni Veins.

The Small Saphenous vein tracks down the back of the calf, from the ankle to the knee crease in most cases, where it forms a connection with the Deep vein System at the Popliteal vein, called the Sapheno-Popliteal junction. In some case there is no connection with the Popliteal vein and instead the vein tracks up the back of the thigh and joins with the Superficial Femoral deep vein or the Great Saphenous superficial vein in the thigh. This section of vein is called the Giacomeni vein. Perforator veins:

Perforator veins
The Perforator veins connect the deep venous system with the superficial venous system, and the lower limb contains in excess of 100 of these connections. The perforators also contain one way valves designed to permit flow of blood from superficial to the deep system and not vice versa.

Continue here to read about how veins work, or select a link in the top menu bar to go straight to a leg complaint.