The thigh extension of the lesser saphenous vein: From Giacomini's observations to ultrasound scan imaging

Background. Giacomini described a vein that now bears his name almost 130 years ago. Subsequent anatomic studies detail his findings but receive inadequate attention in clinical and surgical textbooks. The purpose of this study was to present a summary of the original observations by Giacomini, present our ultrasound scan findings, and review later anatomic, venographic, and ultrasound scan studies. Methods: The study was a literature review and experience with duplex ultrasound scanning from units in Italy and Australia. Results. Giacomini described a thigh extension from the lesser saphenous vein that passed to join with the greater saphenous vein, which since then bears his name, and described also the other destinations of the thigh extention to deep veins through perforators or an end as multiple tributaries in the superficial tissues or muscles. Duplex ultrasound scanning shows that the vein can be affected by varicose disease with reflux either upwards or downwards in the thigh to the greater or lesser saphenous veins respectively. Conclusion: Ultrasound scan imaging has brought the vein of Giacomini from the realm of anatomic dissection to an important structure to be considered in the clinical management of chronic venous disease.