The Superficial Femoral Vein is a Deep Vein...Huh?

Let's stop the confusion! There is no Superficial Femoral Vein!

Many ultrasound technologists are using the term "superficial femoral vein" or "SFV" on their images. In addition, radiologists often use this term in reports. To the best of my knowledge, there is actually no such anatomic structure. The name of the vein between the common femoral vein (CFV) and popliteal vein is the "femoral vein" (FV) [1-4].

Figure 1. A. The ultrasound technologist has incorrectly labeled the image "SFV". B. A different ultrasound technologist has correctly labeled the image "FV".

This misnomer has real consequences - I have personally seen patients not treated for acute DVT as the report has indicated isolated thrombus in the superficial femoral vein. The clinician read the report and thought he did not need to treat the patient with anticoagulants as it was superficial thrombosis.

I would encourage all ultrasound technologists and radiologists to abandon the term "Superficial Femoral Vein" and instead use the term used by the vast majority of anatomists [4], endorsed by The Society of Interventional Radiology (SIR) [3], The Australasia Society for Ultrasound in Medicine (ASUM) [5], and The Interventional Radiology Society of Australasia (IRSA) [6]: "Femoral Vein".

Figure 2. Venous anatomy of the lower extremity demonstrating the femoral vein. Note that it is the vein between the common femoral vein and the popliteal vein. There is no superficial femoral vein.

References:

1. Hammond I. The Superficial Femoral Vein [letter] Radiology. November 2003. Volume 229, Issue 2 p.604.

2. Thiagarajah R, Venkatanarasimha N, Freeman S. Use of the term "superficial femoral vein" in ultrasound. J Clin Ultrasound. 2011 Jan;39(1):32-4.

3. Caggiati A, Bergan JJ, Gloviczki P, Jantet G, Wendell-Smith CP, Partsch H, et al. Nomenclature of the veins of the lower limbs: an international interdisciplinary consensus statement. Journal of Vascular Surgery. 2002;36(2):416-222.

4. Bundens WP, Bergan JJ, Halasz NA, Murray J, Drehobi M. The superficial femoral vein: a potentially lethal misnomer. JAMA. 1995;274:1296–1298.3.

5. Australasia Society for Ultrasound in Medicine (ASUM). Statement on Use of ‘Superficial Femoral Vein’ Term. http://hosted.verticalresponse.com/1278897/74615a8ee1/545444629/804d8fbe22/

6. Interventional Radiology Society of Australasia (IRSA). Use of the term “superficial femoral vein”. http://www.irsa.com.au/news/76-use-of-the-term-superficial-femoral-vein.

Kevin Rice, MD serves as the Medical Director of the Radiology Department of Valley Presbyterian Hospital in Los Angeles, California and is a Member of Renaissance Imaging Medical Associates. Dr. Rice has made several media appearances as part of his ongoing commitment to public education. Dr. Rice's passion for state of the art radiology and teaching includes acting as a guest lecturer at UCLA. In 2015 Dr. Rice launched Global Radiology CME to provide innovative radiology education at exciting international destinations, with the world's foremost authorities in their field. Due to his online teaching activities, Dr. Rice was nominated and became a semifinalist for a "Minnie" award for the Most Effective Radiology Educator in 2016.

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