Anatomy of Perforating veins of the lower limb

Abstract

The perforating veins (PVs) of the lower limbs are not just straight and direct communications between the deep and the superficial venous networks, they are commonly making a complex multi-branched network. Despite their great anatomical variability, their location is remarkably constant and predictable. This is due to their close relationship with the muscular veins, explained by the hemodynamical levels along the limb. This constitutes a help for their assessment by sonographers in daily practice. The anatomical contents of this paper came from the following sources: Anatomical dissections by C. Gillot, after latex injection, then colored segmentation of more than 400 limbs. 3D reconstructions from CT venography of 1200 limbs and pre-surgical skin venous mapping of 25 000 limbs. We successively describe: Landmarks of the limb, perforating veins of foot, leg and ankle, calf, interperforator anastomosis, accompanying arteries of leg PVs, popliteal fossa PVs, thigh PVs.