At this level, the perforating veins usually ensure communication
with the profunda femoris network. Exploration of the short
saphenous vein, even using a simple pocket Doppler frequently
detects reflux above the saphenopopliteal junction, extending
onto the posterior surface of the thigh.
The ultrasonographer will then be faced with two types of situation:

just before it
starts to curve, the saphenopopliteal junction gives rise to
an overlying trunk (
Figure
94). This vessel, initially suprafascial, gradually leaves
the superficial plane to join the intramuscular network of deep
femoral veins in the upper third of the thigh;

more rarely, the
short saphenous vein gives rise to a trunk arising after its
curvature towards the popliteal vein. This trunk remains subfascial
throughout its course (
Figure
93 and
Figure
95). ). Rather than a profunda femoris perforating vein,
this vessel corresponds to a real continuation of the short
saphenous vein, which therefore presents a double termination
in the deep network: popliteal and femoral.
The two situations described above raise a therapeutic problem.
Due to the associated proximal reflux, recurrence can occur
after stripping with saphenopopliteal junction ligation. This
problem could be resolved by sclerosis using an ultrasound-guided
catheter or venous endoscopy.

Further reading
Dortu J., Dortu JA. Les veines perforantes du membre inférieur : physiologie
et physiopathologie. Phlébologie, 1994; 47: 167-75.
Gillot C. Les veines perforantes inférieures de la jambe, de la cheville
et du pied. Phlébologie, 1994; 47: 76-104.
Thomson H. The surgical anatomy of the superficial and perforating veins of
the lower limb. Annals of the Royal College of Surgeons, 1979; 61: 197-205.