scholarly journals Initiation of reticular and spider veins, incompetent perforantes and varicose veins in the saphenous vein network of the rat

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Bernadett Bettina Patai ◽  
Gabriella Dornyei ◽  
Anna-Maria Tokes ◽  
Judit Reka Hetthessy ◽  
Alexander Fees ◽  
...  

Abstract In an attempt to induce experimental varicosity, reverse perforant vein development was initiated in the rat leg by applying a chronic (14 and 32 weeks) partial stricture on the main branch of the deep femoral vein. At surfacing of the incompetent perforantes, typical reticular vein plaques and spider veins were identified by video-microscopy and quantitative histology. Deep vein blood was channeled by them into the saphenous vein system, the extra flow deforming these vessels, causing local dilations and broken course, even undulations of larger branches.


1987 ◽  
Vol 2 (1) ◽  
pp. 1-5 ◽  
Author(s):  
G.M. Glass

Recurrence of varicose veins after surgical treatment by ligation and transection has been usually attributed to development of varicosity in veins collateral to the transected vessels. Early studies reported regeneration of the great saphenous vein at the site of previous transection. The present study in the rat was undertaken to determine whether restoration of normal venous circulation in a limb after surgical interruption of the main vein develops through enlargement of collateral veins or by restoration of continuity of the interrupted vein as a result of neovascularization at the site of ligation. Following ligation in continuity or ligation and surgical transection of the rat common iliac or femoral vein, phlebographic, surgical exploratory and histological studies showed restoration of its continuity through newly formed vessels. These findings suggest that in recurrence of varicose veins the roles of neovascularization and of collateral veins deserve further investigation.



Phlebologie ◽  
2000 ◽  
Vol 29 (03) ◽  
pp. 58-61 ◽  
Author(s):  
G. Madycki ◽  
P. Dabek ◽  
A. Gabrusiewicz ◽  
W. Staszkiewicz

SummaryAim: Authors performed a retrospective analysis of causes of recurrent varicose veins following surgery. Methods: They evaluated 89 patients (65 women and 24 men, mean age 49.7 years). All patients previously underwent same surgical procedures (long saphenous vein stripping with/without local multiple avulsions). For the purpose of the study, colour/duplex examinations were applied (Siemens Sonoline Elegra unit). Results: Depending on the type and area of recurrent varicose veins, patients were classified into 4 groups. Group I – 22 patients (persistence of varicose tributaries of LSV in thigh or thigh perforator). Group II – 27 patients (recurrence along the LSV in the calf). Group III – 26 patients (recurrence due to left incompetent short saphenous vein). Group IV – 14 patients (isolated incompetent perforators). Authors conclude, that colour-coded duplex scanning is currently a method of choice in the diagnosis of recurrent varicose veins. High incidence of recurrence due to short saphenous vein incompetence should draw particular attention to this vein in the preoperative assessment of venous system. Recurrence of varicose veins at thigh level is not caused by deep vein insufficiency, but is related to inadequate vein surgery or might be linked to the problem of neovascularisation in this area.



2015 ◽  
Vol 31 (5) ◽  
pp. 334-343 ◽  
Author(s):  
Jean Francois Uhl ◽  
Miguel Lo Vuolo ◽  
Nicos Labropoulos

Objective To describe the anatomy of the lymph node venous networks of the groin and their assessment by ultrasonography. Material and methods Anatomical dissection of 400 limbs in 200 fresh cadavers following latex injection as well as analysis of 100 CT venograms. Routine ultrasound examinations were done in patients with chronic venous disease. Results Lymph node venous networks were found in either normal subjects or chronic venous disease patients with no history of operation. These networks have three main characteristics: they cross the nodes, are connected to the femoral vein by direct perforators, and join the great saphenous vein and/or anterior accessory great saphenous vein. After groin surgery, lymph node venous networks are commonly seen as a dilated and refluxing network with a dystrophic aspect. We found dilated lymph node venous networks in about 15% of the dissected cadavers. Conclusion It is likely that lymph node venous networks represent remodeling and dystrophic changes of a normal pre-existing network rather than neovessels related to angiogenic factors that occur as a result of an inflammatory response to surgery. The so-called neovascularization after surgery could, in a number of cases, actually be the onset of dystrophic lymph node venous networks. Lymph node venous networks are an ever-present anatomical finding in the groin area. Their dilatation as well as the presence of reflux should be ruled out by US examination of the venous system as they represent a contraindication to a groin approach, particularly in recurrent varicose veins after surgery patients. A refluxing lymph node venous network should be treated by echo-guided foam injection.



2021 ◽  
pp. 1-4
Author(s):  
Zierau UT

The thrombosis in areas of the superficial truncal varicose veins and cutaneous veins is not a rare complication; it requires drug or surgical therapy if the thrombosis grows in the direction of deep veins. This situation is particularly striking in the case of thromboses of the great saphenous vein GSV and small saphenous vein SSV as well as other saphenous veins and leads to deep vein thrombosis in around 20% of cases. We will report about a case of SSV thrombosis and the catheter-based therapy of thrombosis following the therapy of truncal varicose vein SSV with VenaSeal® in one session.



2020 ◽  
Vol 18 (1) ◽  
pp. 99-101
Author(s):  
Vasanthakumar Packiriswamy ◽  
Satheesha B Nayak

Knowledge of normal as well as variant great saphenous vein is useful as it is the vein that can get varicosed; the vein that is used in bypass surgeries and the vein that is used for cannulation purpose. We observed almost complete duplication of the great saphenous vein in the left lower limb of an adult male cadaver. Both the great saphenous veins arose from the medial end of the dorsal venous arch and coursed parallel to each other throughout the limb. They united in the femoral triangle to form a short (1 inch long) common great saphenous vein. Common great saphenous vein terminated into the femoral vein. There were four communicating veins connecting the two great saphenous veins in the leg, giving the appearance of a venous ladder. Knowledge of this variation could be extremely useful in treatment of varicose veins of lower limb, in catheterizations and in various surgical procedures of the lower limb.



1982 ◽  
Vol 63 (4) ◽  
pp. 63-66
Author(s):  
V. E. Mamaev ◽  
M. F. Musin ◽  
M. N. Malinovsky

In 70 patients with varicose veins of the lower extremities, the state of the venous bed of the femoral-iliac segment was studied by methods of proximal pelvic and retrograde-femoral phlebography. The characteristic radiological signs of varicose veins were found: ectasia of the iliac and femoral veins, failure of the valve of the sapheno-femoral anastomosis with reflux of the contrast agent into the great saphenous vein, aneurysmal dilatation of the mouth of the great saphenous vein, partial or complete insufficiency of the valves of the femoral vein. It was found that in 35.7% of cases, the cause of the development of hypertension and varicose veins of the saphenous veins was segmental narrowing of the veins and compression of the femoral vein in the region of the pupar ligament, various extravasal compression of the main veins of the femoral-iliac segment with bone protrusions, a cross-passing artery, and an enlarged uterus. It is recommended, when studying the venous hemodynamics of the lower extremities, simultaneously with the use of distal phlebography, to carry out a contrast study of the pelvic veins



1995 ◽  
Vol 10 (4) ◽  
pp. 132-135 ◽  
Author(s):  
G. M. Somjen ◽  
J. Donlan ◽  
J. Hurse ◽  
J. Bartholomew ◽  
A. H. Johnston ◽  
...  

Objectives: To clarify reflux patterns in the sapheno-femoral junction in legs with varicose veins that display incompetence in the proximal long saphenous vein on duplex scan examination. Patients and method: One hundred consecutive extremities were selected for ultrasound studies. Venous reflux was examined in the common femoral vein and long saphenous vein at five selected levels in the vicinity of the sapheno-femoral junction. Results: Duplex ultrasound examination confirmed that in 44 extremities reflux was detectable both in the long saphenous vein and common femoral vein indicating ‘true’ sapheno-femoral incompetence. In 56 legs reflux was limited to the long saphenous vein, whilst the first saphenous valve remained competent. The ultrasound examination suggested that in these cases the reflux originated from the numerous tributaries of the proximal long saphenous vein. Conclusion: Our findings emphasize the transfascial escape (reflux from the deep veins) is not a necessary precondition of long saphenous vein incompetence and related varicose veins.



Vascular ◽  
2007 ◽  
Vol 15 (5) ◽  
pp. 250-254 ◽  
Author(s):  
Colleen M. Johnson ◽  
Robert B. McLafferty

Symptomatic lower extremity varicose veins represent one of the most common vascular conditions in the adult population. Associated symptoms ranged from mild conditions such as fatigue, heaviness, and itching to more serious conditions such as skin discoloration and leg ulceration. The predominant causative factor of this condition is reflux of the great saphenous vein (GSV), which is traditionally treated with surgical saphenofemoral ligation and stripping of the incompetent saphenous vein. In recent years, there have been significant advances in saphenous vein ablation using percutaneous techniques, including the endovenous laser therapy (EVLT). In this article, the authors discuss the therapeutic evolution of this technology, theoretical basis of laser energy in GSV ablation, and procedural techniques of EVLT using duplex ultrasonography. Additional discussion of procedural-related complications, such as deep vein thrombosis, skin burn, saphenous nerve injury, and phletibis, and ecchymosis, are provided. Lastly, clinical results of EVLT in GSV ablation are discussed. Current literatures support EVLT as a safe and effective treatment option for varicosities caused by GSV incompetence.



Phlebologie ◽  
2010 ◽  
Vol 39 (01) ◽  
pp. 18-23 ◽  
Author(s):  
M. Zaniewski ◽  
T. Urbanek ◽  
A. Dorobisz ◽  
E. Majewski ◽  
U. Skotnicka-Graca ◽  
...  

SummarySurgical treatment of chronic venous disease primarily aims to restore the normal haemodynamic conditions in the venous system. The objective of the study was an assessment of the influence of incompetent saphenous vein removal on the haemodynamical changes within the venous and arterial system of the operated extremity. Patients, materials, methods: The study utilised a group of 50 patients presenting with varicose veins (C2 according to CEAP classification) and great saphenous vein incompetence selected for saphenous vein stripping. In all patients, duplex Doppler examination of femoral and popliteal veins as well as femoral and popliteal arteries was performed before surgery, on the first postoperative day and 30 days after surgery. Results: After the removal of an incompetent great saphenous vein, a statistically significant increase in the minute volume flow in the femoral (p = 0.0004) and popliteal veins (p = 0.0011) was observed. Following saphenous vein stripping, a statistically significant reduction of the venous reflux time in the deep vein system was also observed in the common femoral, femoral and popliteal veins, as compared to a pre-operative examination. Postoperatively, normalisation of the venous reflux time was achieved in 36–40% of patients from the group with concomitant deep vein system incompetence. As far as the arterial system is concerned, an increase in the volume flow in the femoral (p = 0.0463) and popliteal arteries was observed, but statistical significance was not achieved in the latter (p = 0.2912). Conclusion: The flow in the deep vein system increases after the removal of the incompetent great saphenous vein. In some patients with an incompetent deep vein system, venous reflux time returns to normal after the incompetent saphenous vein has been removed.



2020 ◽  
Vol 35 (10) ◽  
pp. 792-798
Author(s):  
Dominic Mühlberger ◽  
Achim Mumme ◽  
Markus Stücker ◽  
Erich Brenner ◽  
Thomas Hummel

Objectives Recurrent varicose veins after surgery are a frequent burden and the saphenofemoral junction is the most common source of reflux. Pre-existing branches of the common femoral vein near the saphenofemoral junction, which may increase due to haemodynamic or other reasons, could play a role in the development of recurrent varices. There exist only a few anatomical data about the prevalence of these minor venous tributaries of the common femoral vein near the saphenofemoral junction. Therefore, this study aimed to elucidate their frequency and distribution. Method A total of 59 veins from 35 anatomical donors were dissected. The common femoral vein with the adherent parts of the profunda femoris vein and the great saphenous vein was exposed and analysed ex situ. The number of minor tributaries to the common femoral vein was counted and their distances to the saphenofemoral junction as well their diameters were measured. Results We could identify up to 10 minor tributaries of the common femoral vein below the level of the great saphenous vein as far as 6 cm distally and up to four veins above the level as far as 5 cm proximally. The mean diameters of these vessels ranged from 0.5 to 11.7 mm. Most of these vessels were located near the saphenofemoral junction and 3 cm distally. Directly opposite to the opening of the great saphenous vein we could find at least one minor tributary of the common femoral vein in 57%. Conclusions There exist a vast number of minor tributaries of the common femoral vein and they are mainly located near the saphenofemoral junction. Nevertheless, their role in the development of recurrent varices is still unclear and further studies are necessary.



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