Anatomical Study of the Gastrocnemius Venous Network and Proposal for a Classification of the Veins

Abstract

Objectives. To present a detailed description of the gastrocnemius venous network. Design. Anatomical study in cadavers. Material and methods. Forty lower limbs from 20 adult male cadavers were studied. All gastrocnemius veins were dissected from the gastrocnemius muscle heads proximally toward their drainage site. Results. Eighty heads of 40 gastrocnemius muscles showed 438 gastrocnemius veins. The number of veins per muscle head varied between 2 and 12. There were 221 gastrocnemius trunks distributed as 95 main gastrocnemius trunks, 81 axial and 45 collateral ones. From the 95 main gastrocnemius trunks, 83 (87%) drained into the popliteal vein. Direct observation of the gastrocnemius venous network allowed us to classify the anatomical distribution as four distinct types. Conclusions. The majority of main gastrocnemius venous trunks drain into the popliteal vein. There is wide variability in the number of gastrocnemius veins. We propose a classification of four distinct types of anatomical pattern.

The Incidence, Clinical Importance and Management of Incompetent Gastrocnemius Vein

“…However, the potential drainage vein needs to be confirmed during the preoperative duplex ultrasound study, because there are many variations of the venous anatomy at the popliteal fossa. 25,26) The incompetency of the GCV can also cause residual varicose veins after surgery for a great saphenous varicose vein, as was observed in our case. A solitary incompetent GCV can cause congestive dermatitis, as experienced by our case.…”

Aberrant medial sural artery causing popliteal vein entrapment syndrome

“…The venous network within the popliteal fossa can be highly variable and the sural arteries can overlie popliteal vein tributaries in normal anatomy. 3 The primitive popliteal artery develops as a fusion of the fetal axial artery proximally and the fetal sciatic artery distally during embryological weeks 6 -10. This development coincides with the migration of the medial head of the gastrocnemius muscle from the lateral epicondyle of the femur across the popliteal fossa to the proximal aspect of the medial femoral condyle before the distal third of the popliteal artery has fully formed.…”

Leg Ulceration Associated with Incompetence of the Gastrocnemius Vein - A Case Report

“…Sometimes, in a patient with an incompetent gastrocnemius vein, varicose veins are not visible and an incompetence of the gastrocnemius vein coexisting with incompetent small saphenous vein, and varicose veins with isolated incompetence of the gastrocnemius vein. Of course, coexisting incompetence in the territory of the great saphenous vein is also possible (1)(2)(3)(4)(5)13). Re-entry points can be localized exclusively in the gastrocnemius vein system, or there could be an additional perforator connected to incompetent small saphenous vein ( fig.…”

“…However, a relatively frequent pathology is also an incompetence of the gastrocnemius vein (1,2,3). Yet, the actual prevalence of varicose veins associated with the incompetence of this vein remains unknown because very few surgeons perform ultrasonic examination prior to surgery for varicose veins, and the reflux in the gastrocnemius vein is assessed even less frequently.…”