Perforators of the leg and calf (venae perforantes cruris)

The perforators of the leg (venae perforantes cruris; PV; or “perforating veins”) are a subset of, and not to be confused with, the larger overarching group of perforating veins of the lower limb.

This group of veins connects the superficial venous systems and deep veins in the calf and are divided into four according to their topography.

Medial leg perforators

Paratibial PV

• join the main trunk or tributaries of the great saphenous vein (GSV) with the posterior tibial veins and course close to the medial surface of the tibia.
• these correspond to the so-called Sherman PV (at the lower and mid leg) and Boyd PV (at the upper leg).

Posterior tibial PV

• posterior tibial perforators (Cockett perforators) connect the posterior accessory great saphenous vein with the posterior tibial veins.
• these correspond to the so-called Cockett PV and they can be indicated topographically as upper, middle, and lower

Anterior leg perforators

• pierce the anterior tibial compartment and connect the anterior tributaries of the GSV to the anterior tibial veins

Lateral leg perforators

• connect veins of the lateral venous plexus with the fibular veins

Posterior leg perforators

• medial gastrocnemius perforators (in the medial calf)
• lateral gastrocnemius perforators (in the lateral calf
• intergemellar perforators (connecting the SSV with the calf veins, also called “mid-calf perforator of May”)
• para-Achillean perforators (connecting the SSV with the fibular veins; also called “perforator of Bassi”)