Where are perforator veins found?
The whole of the venous function of the leg is aimed at pumping blood from the foot and tissues of the leg back to the heart. This means that all of the major veins, have to pump blood upwards against gravity. To do this, blood has to flow first into the deep veins where this pumping can take place.
Blood that has been taken to the bones and muscles by the arterial system, drains directly into these and then into the veins once it is given off its nutrients and picked up the waste products of metabolism. However blood that has been used to provide nutrition to skin, fat and nerves of the leg is outside of this muscle layer. In this position, the blood cannot be pumped back to the heart by the muscle in the leg.
Therefore, it is essential that blood in the superficial veins is taken into the deep veins within the muscle be pumped back to the heart and to complete the venous circulation.
The two major veins in the leg, the great saphenous vein (GSV) and the small saphenous vein (SSV), both perforate the fascia themselves, forming important junctions with the deep system called the saphenofemoral junction (SFJ) and the saphenopopliteal function (SPJ) respectively.
Although these are the two major junctions between the superficial venous system of the leg and the deep venous system of the leg, there are approximately another 150 communications via perforating veins. Although these are found all over the leg, they are not distributed evenly. They follow the venous anatomy on the surface as well as the venous anatomy of the deep veins as these are the two systems that have to be connected. As such, the majority of perforating veins are found on the inner aspect of the lower leg with fewer on the outer aspect of the lower leg and inner aspect of the thigh.
There are a few perforating veins in more complex areas such as behind the knee and just below the ankle on the foot.