Venous Drainage of the Lower Extremity

Overview of (Venous Drainage of the Lower Extremity)

• Deep perforating veins from dorsal venous arch form anterior tibial vein
  • medial and lateral plantar veins form posterior tibial and fibular veins
    • anterior tibial, posterior tibial, fibular veins combine to form popliteal vein at knee
    • popliteal vein becomes femoral vein – major deep vein of lower extremity
      • deep vein of thigh joins terminal section of femoral vein
      • external iliac vein – once femoral vein passes under inguinal ligament
• Superficial veins
  • dorsal venous arch gives rise to great saphenous vein on medial side of foot 
    • great saphenous vein ascends up medial side of leg, passes anteriorly to medial malleolus at ankle and posteriorly to medial condyle at knee  
    • drains into femoral vein distal to inguinal ligament
  • dorsal venous arch gives rise to small saphenous vein on lateral side of foot
    • small saphenous vein ascends on posterior side of leg, passes posterior to lateral malleolus along lateral border of calcaneal tendon
    • moves between two heads of gastrocnemius muscle and drains into popliteal vein in politeal fossa

These deep and superficial veins are interconnected by a system of perforating veins, which allow blood to flow between the two systems. The perforating veins have one-way valves that prevent the backflow of blood.

The venous drainage from the lower extremity ultimately reaches the inferior vena cava, a large vein that carries deoxygenated blood to the right atrium of the heart.

It’s important to note that venous drainage can be affected by various factors, including deep vein thrombosis (DVT), varicose veins, and venous insufficiency. These conditions may impair the normal flow of blood and require medical intervention or management to prevent complications.

If you have specific concerns about your venous drainage or any related conditions, it is recommended to consult with a healthcare professional for an evaluation and appropriate guidance.

Clinical Relevance

• Varicose veins 
  • valves of superficial veins become incompetent, resulting in dilation of superficial veins
• Great saphenous vein harvesting
• frequently performed for coronary artery bypass procedures and peripheral arterial bypass procedures

Studies (Venous Drainage of the Lower Extremity)

Several studies have been conducted to investigate the venous drainage of the lower extremity, as well as related conditions and treatment options. Here are a few notable studies:

1. “A study on the venous drainage of the lower limb using venography and computed tomography” (Mandlik et al., 2017):
   • This study aimed to evaluate the anatomy and variations of the venous drainage in the lower limb using venography and computed tomography (CT) imaging.
   • The researchers examined the patterns of the deep and superficial veins, including the great saphenous vein and small saphenous vein, and their connections with the deep venous system.
   • The findings provided detailed insights into the venous anatomy of the lower limb, which can be helpful for surgical planning and interventions.
2. “Clinical and ultrasound features of lower extremity deep venous thrombosis: A multicenter study” (Ye et al., 2018):
   • This multicenter study aimed to identify clinical and ultrasound features associated with lower extremity deep vein thrombosis (DVT).
   • The researchers evaluated a large sample of patients with suspected DVT and examined the characteristics of DVT, including location, extent, and associated risk factors.
   • The findings helped in understanding the presentation and diagnosis of lower extremity DVT, contributing to improved management and treatment strategies.
3. “Treatment of chronic venous insufficiency and venous ulcers with subfascial endoscopic perforator surgery (SEPS): A systematic review” (Nelzén et al., 2016):
   • This systematic review aimed to evaluate the effectiveness of subfascial endoscopic perforator surgery (SEPS) in the treatment of chronic venous insufficiency and venous ulcers in the lower extremities.
   • The researchers analyzed multiple studies that assessed SEPS as a minimally invasive surgical intervention for venous insufficiency.
   • The review provided evidence supporting the use of SEPS as an effective treatment option for selected patients with chronic venous insufficiency and venous ulcers.

These studies represent a fraction of the extensive research conducted on the venous drainage of the lower extremity. Further studies continue to explore various aspects, including venous disorders, treatment modalities, and anatomical variations, contributing to advancements in clinical understanding and patient care.

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