Duplex Ultrasound Investigation of the Veins in Chronic Venous Disease of the Lower Limbs—UIP Consensus Document. Part II. Anatomy

(A) Transverse B mode ultrasound image of the great saphenous vein (GSV) in the saphenous compartment of the thigh. (B) Position of the ultrasound probe in the thigh.

Anterior accessory saphenous vein (AASV) and the alignment sign. (A) The AASV lies laterally to the GSV and these two veins terminate in a common trunk (SFJ). (B) B-mode ultrasound image of the SFJ. The left image shows the common trunk (SFJ). On the right, 2cm more distally, the AASV lies laterally to the GSV. Note: the AASV overlies and alligns with the femoral vessels (femoral vein, superficial femoral artery and deep femoral artery) whilst the GSV passes more medially.

B-mode ultrasound image just below the knee in two different limbs. Tibia (T)–gastrocnemius (G) angle with great saphenous vein inside (A) and without GSV (B) (due to congenital absence or hypoplasia of GSV); a large saphenous tributary is present in image B (circled).

Relationship between the great saphenous vein and a tributary in the mid thigh area (A) diagram showing the position of the GSV and of its (incompetent) tributary (B) transverse colour-duplex image: left: GSV within the saphenous eye right: (incompetent) tributary above the saphenous fascia and (small, competent) GSV within the saphenous eye (right).

Great saphenous vein (GSV) and small saphenous vein (SSV) terminal valve (TV) and pre-terminal valve (PTV) (A) saphenofemoral junction and GSV; the arrow on the left indicates TV and the arrow on the right indicates PTV (B) on the left TV during antegrade flow, on the right TV during valsalva manoeuvre (the arrows indicate TV leaflets) (C) saphenopopliteal junction and TV (TERVAL) of SSV close to the popliteal vein (POPV).

Relation of fascial compartments to the GSV and anatomical variations at the knee.⁶

Relationship between the GSV and tributaries: I, h and S type configurations.

The saphenopopliteal junction—anatomical variations.

Transverse scan of the posterior thigh and leg region. Small saphenous vein (SSV) and its thigh extension (TE), both within the saphenous compartment (a) lower third of the thigh (b) saphenopopliteal junction (SPJ) (c) upper third of the leg.