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(Circulation. 1999;100:2547.)
© 1999 American Heart Association, Inc.

Images in Cardiovascular Medicine

Fascial Relationships of the Long Saphenous Vein

Alberto Caggiati, MD, PhD

From the Department of Anatomy, University of Rome "La Sapienza," Rome, Italy.

Correspondence to Alberto Caggiati, MD, PhD, Department of Anatomy, University of Rome "La Sapienza," Via A. Borelli 50, I-00161, Rome, Italy.

The long saphenous vein runs constantly in a deep plane of the hypodermis, lying directly above the muscular fascia (Figure 1). It is covered for its full length by a connective lamina that descends from the inguinal ligament to the ankle in the hypodermis of the medial thigh and leg. This lamina, which is formed by the interlacing of the hypodermal connective sheets, until now has been only partially described,¹ and it is called the "saphenous fascia" to distinguish it from similar structures present in other regions of the human body.²

View larger version (116K): [in this window] [in a new window]   Figure 1. Stereomicroscopy of a cross section of medial thigh hypodermis taken during necroscopy showing fascia and compartment of long saphenous vein. Inset: A correlated transverse echotomograph of medial thigh hypodermis. * indicates long saphenous vein; arrowheads, saphenous fascia; MF, muscular fascia; D, dermis; and arrow, saphenous nerve.

After having arched over the long saphenous vein, this hypodermic fascia fuses with the muscular fascia, thus delimiting a flat, fatty, continuous space from the groin to the ankle (Figure 2A). This space could be considered the "saphenous compartment,"¹ because it is clearly circumscribed and is occupied only by the saphenous vein and nerve (Figure 1).

View larger version (150K): [in this window] [in a new window]   Figure 2. A, Typical ultrasonographic shape of saphenous "eye." B, Transverse ultrasonography of medial thigh hypodermis showing different planar topography of saphenous vein (below saphenous fascia) and 1 tributary vessel. C, Typical ultrasonographic aspect of a saphenous tributary vein that is surrounded only by hypoechogenic loose adipose tissue. * indicates long saphenous vein; arrowheads, saphenous fascia; . . . [Full Text of this Article]

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