[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Lower limb](https://durgical.com/en/anatomy/region/lower-limb/) › Small saphenous vein [Cardiovascular system](https://durgical.com/en/anatomy/system/cardiovascular-system/) · [Lower limb](https://durgical.com/en/anatomy/region/lower-limb/) # Small saphenous vein The small saphenous vein is a surface vein that runs from the outer foot, behind the outer ankle, up the back of the calf. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=lower_limb&select=small_saphenous_vein&side=r) Opens in the Durgical app, no sign-up needed. ## What it is A surface vein that starts on the outer edge of the foot, passes behind the outer ankle bone and runs up the back of the calf. ## What it does Drains blood from the [skin](https://durgical.com/en/anatomy/skin/) into the popliteal vein behind the knee. ## Key points - Runs with the [sural nerve](https://durgical.com/en/anatomy/sural-nerve/) from behind the lateral malleolus up the calf, so surgery or ablation on it can leave numbness along the lateral foot - Ends at the saphenopopliteal junction, usually a little above the knee crease, but the level varies so much that the junction is marked on duplex ultrasound before any procedure - Lies in the subcutaneous tissue in the lower calf and under (or within) the deep fascia higher up, between the heads of gastrocnemius ## Key facts **Drains** Lateral end of dorsal venous arch, behind lateral malleolus; posterior leg (runs with sural nerve) **Into** Popliteal vein in popliteal fossa (varies: may end higher, in femoral or great saphenous vein) ## Relations **Course** From the lateral end of the dorsal venous arch it passes behind the lateral malleolus, runs up beside the lateral border of the [Achilles tendon](https://durgical.com/en/anatomy/calcaneal-tendon/) to the midline of the calf, pierces the deep fascia and ends in the [popliteal vein](https://durgical.com/en/anatomy/popliteal-vein/) in the fossa **Deep** The two heads of gastrocnemius, with the medial sural cutaneous nerve beside it in the groove between them **Above** A cranial extension may continue up the back of the thigh; when it joins the [great saphenous vein](https://durgical.com/en/anatomy/great-saphenous-vein/) it is called the Giacomini vein ## How to find it With the person standing and facing away, it is seen behind the lateral malleolus and along the outer edge of the Achilles tendon, then up the middle of the calf. It disappears from view in the upper calf, where it runs under the deep fascia. ## Examination - Duplex ultrasound with the person standing: reflux lasting more than 0.5 seconds at the saphenopopliteal junction after a calf squeeze is released confirms that the junction is incompetent - Tourniquet test below the knee crease: if the posterior calf varicosities stay empty on standing with the band in place, the leak is at the saphenopopliteal junction (largely replaced by duplex) ## On imaging Duplex ultrasound with the patient standing: in a transverse view of the calf it sits in a fascial compartment between the two gastrocnemius heads, near the sural nerve. The scan marks the level of the saphenopopliteal junction and tests for reflux, shown as backward flow after a calf squeeze. A thrombus shows as a non-compressible vein. CT and MRI are rarely needed. ## Common problems - Varicose veins. ## Clinical notes - Saphenopopliteal reflux causes varicose veins on the back and outer side of the calf - Superficial thrombophlebitis near the junction can extend into the popliteal vein - An alternative bypass conduit when the great saphenous vein is missing or unsuitable - Surgery at the junction also puts the [tibial nerve](https://durgical.com/en/anatomy/tibial-nerve/) and [common fibular nerve](https://durgical.com/en/anatomy/common-fibular-nerve/) at risk, as they lie close by in the popliteal fossa - Superficial lymph vessels from the lateral foot and back of the calf run with it to the popliteal nodes, so infection there may enlarge popliteal nodes before groin nodes ## Anatomical variants - Often ends higher than the fossa: in the [femoral vein](https://durgical.com/en/anatomy/femoral-vein/), in the great saphenous vein through the Giacomini vein, or in deep thigh veins - Less often ends lower, in the gastrocnemius veins or in the great saphenous vein in the calf - The point where it pierces the deep fascia varies from the lower to the upper calf ## Development It comes from the postaxial (fibular-side) marginal vein of the limb bud, the counterpart of the great saphenous vein on the preaxial side. ## Related conditions - [Varicose veins](https://durgical.com/en/conditions/varicose-veins/) - [Chronic venous insufficiency](https://durgical.com/en/conditions/chronic-venous-insufficiency/) - [Superficial thrombophlebitis (superficial vein thrombosis)](https://durgical.com/en/conditions/superficial-thrombophlebitis/) ## Test yourself Think of the answer, then tap the question to see it. ## Where does the small saphenous vein usually end? In the popliteal vein at the saphenopopliteal junction, but the level varies so much that it is marked on duplex ultrasound before any procedure. ## Which nerve runs with the small saphenous vein, and what can its surgery leave? The sural nerve; surgery or ablation on the vein can leave numbness along the lateral foot. ## Where does the small saphenous vein begin and run in the lower leg? From the lateral end of the dorsal venous arch, behind the lateral malleolus and beside the lateral border of the Achilles tendon. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/anatomy/small-saphenous-vein/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** vena saphena parva TA2 5085 **Official Spanish (DeCS)** Vena safena menor DeCS D012501 **English (TA2)** Small saphenous vein **Also called** short saphenous vein ## Related - [Popliteal vein](https://durgical.com/en/anatomy/popliteal-vein/) - [Sural nerves](https://durgical.com/en/anatomy/sural-nerve/) - [Top-of-foot veins](https://durgical.com/en/anatomy/dorsal-venous-arch-of-foot/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=12878&filter=ths_termall&q=Vena%20Safena); [Anatomy, Bony Pelvis and Lower Limb: Popliteal Region](https://www.ncbi.nlm.nih.gov/books/NBK532891/); Tratado de anatomía humana (9.ª ed.), tomo II, Libro IV Angiología, sección 5: Linfáticos. ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/small-saphenous-vein/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/small-saphenous-vein/