Accessibility of calf perforating veins from the superficial posterior compartment: an anatomic dissection study.

Abstract

to determine the anatomic location of medial perforating veins (PVs) and their course within the compartments of the leg. the lower extremity veins of 15 cadavers were filled with coloured latex solution. Medial PVs between the ankle and the knee were dissected out. in total 95 direct PVs (mean 6.3 per extremity, range 3-9) were identified and classifed as Cockett I, II, or III, proximal and distal paratibial and Boyd. Cockett PVs were present in more than half of the cases, of which the majority (except Cockett I) were located in the superficial posterior compartment. Whereas the vast majority of Cockett PVs originate from the posterior arch vein, the other perforators originate from the greater saphenous vein. only 62% of all PVs pass through the superficial posterior compartment. As a result, during subfascial endoscopic perforating vein surgery (SEPS), at least one third of patients require a paratibial fasciotomy in order to reach and ligate the PVs.