Variable Venous Anatomy of the Popliteal Fossa Demonstrated by Duplex Scanning

Abstract

BACKGROUND: Location of the sapheno-popliteal junction (SPJ) is highly variable and therefore often difficult to identify correctly at operation. The anatomy is often complicated by associated pathology in the popliteal fossa, which makes clinical examination unreliable. OBJECTIVE: The purpose of our study was to quantify this variability and record other concomitant pathology in patients with sapheno-popliteal junction incompetence. METHODS: We retrospectively reviewed duplex scans of 544 patients with 638 legs showing SPJ incompetence, from a total of approximately 4000 patients attending our laboratory between August 1993 and August 1995. RESULTS: We found that 51% of sapheno-popliteal junctions were located within 2 cm above the popliteal skin crease and a further 36% within 4 cm, with the remaining situated anywhere between 4 and 10 cm above the popliteal skin crease. Additionally 18% of patients had either Giacomini or gastrocnemius vein incompetence in addition to SPJ incompetence, further complicating the clinical picture. CONCLUSION: When SPJ incompetence is suspected, duplex scanning identifies the exact location of the junction and other associated pathology in the popliteal fossa, and allows the position of the junction to be marked on the leg preoperatively.