As much as the surgery of the distal end of the internal saphenous vein is simple and followed with good results, the surgery of the distal end of the external saphenous vein remains questionable and followed with varicose veins recurrences. This is the result of numerous anatomical variations of the external saphenous vein as it reaches the deep venous system. In order to ease the dissection of the distal portion of the external saphenous vein, it is important to specify its anatomy. Per-operative opacification by direct injection in the distal portion of the vein or one of its branches, visualizes communications between the superficial external saphenous and the deep system and assists the surgeon in interrupting these communications. In a few rare cases, the anatomy appears to be so atypical, that one cannot hope for a stable post-operative result.
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