Does a Varicose Saphenous Vein Exist?

1997 ◽  
Vol 12 (2) ◽  
pp. 74-77 ◽  
Author(s):  
P. Zamboni ◽  
M. Cappelli ◽  
M. G. Marcellino ◽  
A. P. Murgia ◽  
L. Pisano ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Longitudinal Vein ◽  
Medial Aspect ◽  
Long Saphenous Vein ◽  
Saphenous Veins ◽  
Ultrasound Evaluation ◽  
Primary Varicose Veins ◽  
High Resolution Ultrasonography

Objective: Duplex ultrasound evaluation of the clinically diagnosed varicose long saphenous vein (LSV). Design: Prospective, single patient group study. Setting: Department of Surgery, University of Ferrara, Italy (teaching hospital). Patients: 378 patients, 509 limbs with primary varicose veins; 94 patients, 103 limbs with a visible, superficial varicose vein trunk on the medial aspect of the thigh. Main outcome measure: Duplex ultrasound detection of a varicose saphenous vein and/or segmental saphenous dilatation and their relationship to saphenous reflux. Results: In 98% of cases the varicose trunk visible in the thigh was demonstrated to be a tributary of the saphenous vein; 34% of the observed saphenous veins exhibited segmental dilatations in the thigh. This finding was related in every case to saphenous vein reflux with high velocity and turbulence ( p < 0.0001). Conclusions: High-resolution ultrasonography demonstrated that when a dilated varicose longitudinal vein trunk is visible and palpable on the medial aspect of the thigh it is most likely to be a tributary rather than the LSV. In addition, a varicose saphenous vein along its entire length essentially does not exist. However, when a dilated saphenous segment occurs, it seems to be related to high diastolic flow velocity and turbulence.

Does a Double Long Saphenous Vein Exist?

1999 ◽  
Vol 14 (2) ◽  
pp. 59-64 ◽  
Author(s):  
S. Ricci ◽  
A. Caggiati
Keyword(s):  
Saphenous Vein ◽  
Lower Limb ◽  
Healthy Subjects ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Clear Definition ◽  
Arterial Grafts ◽  
Long Saphenous Vein ◽  
Saphenous Veins ◽  
Definition Of

Background: The incidence of reduplication of the long saphenous vein (LSV) reported in the literature is highly variable, perhaps due to the lack of a clear definition. Objective: To use ultrasonography to re-evaluate the incidence of LSV reduplication in healthy subjects and Patients with varicose veins on the basis of a new definition of this anatomical aspect. Methods: The presence of two parallel superficial venous channels in the lower limb was sought in a series of 610 duplex ultrasound examinations. The LSV was identified, by the ‘eye’ sign, running deeply in the hypodermis, closely ensheathed by two hyperechogenic laminae (the saphenous compartment). Tributary veins were identified by their more superficial course, lying outside the compartment. True LSV reduplication was considered to be present when two venous channels were Present within the saphenous compartment. Results: True reduplication of the LSV is extremely rare (1%) and only affects a segment of vein. Large tributaries running parallel to the LSV do not comprise true reduplication, but may act as a ‘functional double vein’. Better understanding of the anatomy of the LSV may improve operative treatment for varicose veins and improve the use of saphenous veins as arterial grafts.

Echoanatomical Patterns of the Long Saphenous Vein in Patients with Primary Varices and in Healthy Subjects

1999 ◽  
Vol 14 (2) ◽  
pp. 54-58 ◽  
Author(s):  
S. Ricci ◽  
A. Caggiati
Keyword(s):  
Saphenous Vein ◽  
Healthy Subjects ◽  
Duplex Ultrasound ◽  
Normal Subjects ◽  
Predisposing Factor ◽  
Long Saphenous Vein ◽  
Saphenous Veins ◽  
Ultrasound Evaluation ◽  
Congenital Origin

Objective: To evaluate the pathway of reflux in incompetent long saphenous veins (LSVs), paying particular attention to the role of longitudinal saphenous tributaries in the thigh (accessory saphenous veins, ASVs). Design: Prospective study in a group of patients with primary varices. Comparison with the anatomical patterns in a group of normal subjects. Setting: Private phlebology practice. Patients: Sixty-seven patients with primary varices (100 limbs) and 66 subjects without varices and with competent saphenous veins (120 limbs). Methods: Duplex ultrasound evaluation of the saphenous system in the thigh of patients and healthy subjects. The ‘eye’ ultrasonographic sign was used as the marker to distinguish the LSV from the longitudinal tributary veins of the thigh. Results: In 57% of limbs in patients with varices, reflux followed the saphenous vein, while in 43% the reflux spilled outside the LSV into an ASV (h or S types). When reflux followed the saphenous vein, no large calibre ASVs could be observed. In 30% of limbs in control subjects a parallel tributary vein with a similar calibre was found joining the LSV. Conclusion: Clinically visible varices in the thigh rarely comprise the LSV itself, but are usually dilated ASVs, the reflux stream passing from the proximal LSV into a more superficial ASV. The distal LSV running parallel beneath is often competent. In subjects with healthy LSVs, a large competent tributary vein is already present in the thigh in 30% of cases. This suggests that superficial deviation of reflux flow into an ASV in patients with varices may not arise from haemodynamically acquired changes, but could have a congenital origin. This could even be a predisposing factor in the development of varices.

Duplex Ultrasound Scanning for Chronic Venous Disease: Recurrent Varicose Veins in the Thigh after Surgery to the Long Saphenous Vein

1996 ◽  
Vol 11 (3) ◽  
pp. 125-131 ◽  
Author(s):  
K. A. Myers ◽  
G. H. Zeng ◽  
R. W. Ziegenbein ◽  
P. G. Matthews
Keyword(s):  
Saphenous Vein ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Chronic Venous Disease ◽  
Injection Sclerotherapy ◽  
Venous Disease ◽  
Ultrasound Scanning ◽  
Recurrent Varicose Veins ◽  
Long Saphenous Vein ◽  
Primary Varicose Veins

Objective: To use duplex ultrasound scanning to compare limbs with recurrent and primary varicose veins and to identify connections between deep veins and recurrences. Setting: A non-invasive vascular laboratory in Melbourne, Australia. Patients: A study of 779 limbs with recurrent varicose veins previously treated by ligation or stripping of the long saphenous vein and 1521 limbs with primary varicose veins. Main outcome measures: Connections between deep veins and recurrent varices, reflux in superficial and deep veins, and outward flow in perforators as demonstrated by duplex ultrasonography. Results: Recurrence was due to reflux in the long saphenous territory in 71.8%, short saphenous reflux alone in 14.7% or outward flow in calf perforators without saphenous reflux in 5.2%, while no source was detected in 8.3%. Limbs with recurrent veins in the long saphenous territory were compared with limbs with primary varicose veins; there was more frequent outward flow in thigh perforators (25.2% vs. 16.2%) but no difference for deep reflux (20.7% vs. 17.5%) or outward flow in calf perforators (56.8% vs. 53.1%). The source for recurrence in the long saphenous territory was from a single large connection in the groin in 46.3%, multiple smaller proximal connections in a further 46.3%, or thigh perforators in 7.4%. The destination was to an intact long saphenous vein in 33.7%, major tributaries in 28.7% or to other varices in 37.6%. Limbs known to have been treated by long saphenous ligation alone were compared with those known to be treated by long saphenous ligation and stripping; the source was more likely to be from a single large vein in the groin (60.3% vs. 39.9%) and the destination was more likely to be an intact long saphenous vein or major tributary (75.0% vs. 55.2%). Conclusions: Duplex ultrasound scanning detected the source of recurrent varicose veins in over 90% of patients and demonstrated whether there were single large or multiple smaller connections in the veins affected, and this helps to select the most appropriate treatment. Recurrence after stripping the long saphenous vein was more likely to be due to multiple small connections passing to scattered varices and this may allow more simple treatment by injection sclerotherapy rather than repeat surgery.

Haemodynamic Correction of Varicose Veins (CHIVA): An Effective Treatment?

1996 ◽  
Vol 11 (3) ◽  
pp. 98-101 ◽  
Author(s):  
P. Zamboni ◽  
C.V. Feo ◽  
M. G. Marcellino ◽  
G. Vasquez ◽  
C. Mari
Keyword(s):  
Saphenous Vein ◽  
Continuous Wave ◽  
Varicose Veins ◽  
Venous Pressure ◽  
Vein Thrombosis ◽  
Long Saphenous Vein ◽  
Group A ◽  
Primary Varicose Veins ◽  
Short Saphenous Vein ◽  
Group B

Objective: Evaluation of the feasibility and utility of haemodynamic correction of primary varicose veins (French acronym: CHIVA). Design: Prospective, single patient group study. Setting: Department of Surgery, University of Ferrara, Italy (teaching hospital). Patients: Fifty-five patients with primary varicose veins and a normal deep venous system (ultrasonographic criteria) were studied. Interventions: Fifty-five haemodynamic corrections by the CHIVA method described by Franceschi were undertaken. Seven patients were treated for short saphenous vein varices (group A) while 48 patients were treated for long saphenous vein varices (group B). Main outcome measures: Clinical: presence of varices and reduction in symptoms. Duplex and continuous-wave Doppler detection of re-entry through the perforators and identification of recurrences or new sites of reflux. Postoperative ambulatory venous pressure and refilling time measurements. Patients were studied for 3 years following surgery. Results: In group A, 57% short saphenous vein occlusions with no re-entry through the gastrocnemius and soleal veins were recorded. In group B the long saphenous vein thrombosis rate was 10%. In this group 15% of the patients showed persistence of reflux instead of re-entry at the perforators. Early recurrences were also observed. Overall CHIVA gave excellent results in 78% of the patients. Statistically significant ambulatory venous pressure and refilling time changes were recorded ( p<0.001). Conclusions: CHIVA treatment is inadvisable for short saphenous vein varices. Long saphenous vein postoperative thrombosis is related to development of recurrences

The Elastic Properties of the Human Great Saphenous Vein in Relation to Primary Varicose Veins

1974 ◽  
Vol 52 (2) ◽  
pp. 153-157 ◽  
Author(s):  
J. Kenneth Booking ◽  
Margot R. Roach
Keyword(s):  
Elastic Properties ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Simultaneous Measurements ◽  
Saphenous Veins ◽  
Before And After ◽  
Laplace’S Law ◽  
Primary Varicose Veins ◽  
Laplace's Law

Simultaneous measurements of pressure and volume were made on nine great saphenous veins obtained at autopsies and nine great saphenous veins that were stripped during surgery from patients with primary varicose veins. Similar measurements were also made on six great saphenous veins obtained at autopsy before and after they were held at 100 cm H2O for 4 h. Circumferential tensions were calculated from Laplace's law (tension = pressure × radius).The great saphenous veins from patients with primary varicose veins had significantly greater radii and were more distensible than the normal great saphenous veins. After being held at 100 cm H2O for 4 h, the normal great saphenous veins became less distensible and their radii at distending pressures increased.Due to the great difference in radii, the circumferential tension on a great saphenous vein from a patient with primary varicose veins is much greater than that on a normal great saphenous vein at the same distending pressure. However, the physical stresses exerted on the great saphenous veins during the stripping operations may influence our results in some unknown way.

scholarly journals Primary varicose veins: Frequency, clinical significance and surgical treatment

2004 ◽  
Vol 132 (11-12) ◽  
pp. 398-403
Author(s):  
Dragan Vasic ◽  
Lazar Davidovic ◽  
Zivan Maksimovic ◽  
Aleksandra Crni ◽  
Miroslav Markovic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Saphenous Vein ◽  
Varicose Veins ◽  
World Health ◽  
Superficial Thrombophlebitis ◽  
Perforating Veins ◽  
Long Saphenous Vein ◽  
Significant Difference ◽  
Primary Varicose Veins ◽  
Short Saphenous Vein

INTRODUCTION According to the definition of the World Health Organization, varicose veins represent abnormally enlarged superficial veins having baggy or cylindrical shape. The most frequent cause of primary varicose veins is the insufficiency of long saphenous vein (LSV), but especially the basin of its connection with femoral vein and perforating veins. OBJECTIVE The objectives of these investigations were: the determination of insufficiency incidence of SSV in cases of LSV insufficiency; the establishment of association of insufficiency of perforating veins of the basin of LSV and SSV; the study of the results of surgical treatment of insufficiency and varicosity of both short and long saphenous veins. METHODS In this study, 100 patients (66 women and 34 men), average age 52.1 years, with clinical symptoms showing the insufficiency and varicosity of long saphenous vein with no change of deep vein system were examined. Ultrasonographic examinations were made using Color Doppler probes - 7.5 and 3.75 MHz (Toshiba Corevison SSA 350 A); the development of incompetence of long saphenous vein (LSV) and short saphenous vein (SSV) at the level of the junction as well as other incompetent valves were examined. The reflux was defined as a retrograde flow of the duration longer than 0.5 seconds. RESULTS The insufficiency of short saphenous vein was determined by ultrasonographic examination in 34%, while the insufficiency of perforating veins in 80% of patients. 40% of patients were operated (33.3% of females, and 52.9% of males). The most frequent indications for surgical treatment of superficial veins insufficiency were: strong varicosities, clear symptoms and signs, superficial thrombophlebitis and conditions after superficial thrombophlebitis. Surgical treatment was applied in 16% of patients due to recurrence in the basin of long saphenous vein, and in 6% of cases because of the recurrence in the basin of short saphenous vein. Data analysis failed to discover any statistically significant difference between the age of patients and varicosities in the basin of long saphenous vein as well as in the basin of short saphenous vein (51.98?9.97 years; 54.50?31.82 years; t=0.36; p>0.05), or any significant difference of BMI value, with regard to the obesity of patients and varicosities in the basin of long saphenous vein as well as in the basin of short saphenous vein (28.02?4.61 kg/m2; 24.50?6.36 kg/m2; t=0.50; p>0.05). No statistically significant correlation was found between Color Duplex findings of insufficiency of both long saphenous vein and short saphenous vein (p=-0.21 ; p>0.05), nor any significant correlation of Color Duplex findings of perforating veins insufficiency in the basin of long saphenous vein and short saphenous vein (p=-0.115; p>0.05). CONCLUSION The incidence of insufficiency is significant: approximately every third patient has short saphenous vein insufficiency, while three third of patients have perforating veins insufficiency. Color Duplex limb's veins ultrasonography is highly reliable method for the examination and study of superficial veins diseases, which is very important for preoperative decision-making and selection of surgical technique as well as for postoperative follow-up.

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