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.

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.

Lower Limb Deep Venous Incompetence is Rare in Patients Undergoing Obesity Surgery

2000 ◽  
Vol 15 (1) ◽  
pp. 30-32 ◽  
Author(s):  
A. Westling ◽  
A. Boström ◽  
S. Gustavsson ◽  
S. Karacagil ◽  
D. Bergqvist
Keyword(s):  
Lower Limb ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Femoral Vein ◽  
Clinical Signs ◽  
Duplex Ultrasound ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Saphenous Veins ◽  
The Common

Objective: To investigate the incidence of lower limb venous insufficiency in morbidly obese patients. Patients and methods: The study group comprised 125 patients (109 women, 16 men). The median (range) age and body mass index were 35 (19–59) years and 42 (32–68) kg/m2 respectively. Eleven patients had clinical signs of varicose veins or had previously undergone varicose vein surgery. Patients were investigated with duplex ultrasound scanning on the day before surgery. Iliac, femoral, popliteal, and long and short saphenous veins in both legs were studied. Results: A total of 33 patients had abnormal reflux in the superficial veins (>0.5 s). In the deep veins 2 patients had valvular incompetence in the common femoral vein with reflux times of 2 and 0.7 s respectively. At reinvestigation 18 and 24 months after surgery the reflux times were normalised. Conclusion: In this study the incidence of deep venous incompetence in the lower limb in morbidly obese patients is low.

Arteries masquerading as varicose veins: A trap for phlebologists

2014 ◽  
Vol 30 (10) ◽  
pp. 729-735 ◽  
Author(s):  
L Jones ◽  
K Parsi
Keyword(s):  
Saphenous Vein ◽  
Lower Limb ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Tissue Loss ◽  
Injection Sclerotherapy ◽  
Ultrasound Guided ◽  
History Of ◽  
The Right

Ultrasound guided sclerotherapy may be complicated by intra-arterial injections resulting in significant tissue necrosis. Here, we present a 69-year-old man with a history of right small saphenous vein “stripping”, presenting for the treatment of symptomatic lower limb varicose veins. Duplex ultrasound of the right lower limb outlined the pathway of venous incompetence. Despite the history of “stripping”, the small saphenous vein was present but the sapheno-popliteal junction was ligated at the level of the knee crease. No other unusual findings were reported at the time. During ultrasound guided sclerotherapy, subcutaneous vessels of the right posterior calf were noted to be pulsatile on B-mode ultrasound. Treatment was interrupted. Subsequent angiography and sonography showed absence of the right distal popliteal artery. A cluster of subcutaneous vessels of the right medial and posterior calf were found to be arterial collaterals masquerading as varicose veins. Injection sclerotherapy of these vessels would have resulted in significant tissue loss. This case highlights the importance of vigilance at the time of treatment and the invaluable role of ultrasound in guiding endovenous interventions.

scholarly journals Saphenous Ladder Formed by Almost Completely Duplicated Great Saphenous Vein

2020 ◽  
Vol 18 (1) ◽  
pp. 99-101
Author(s):  
Vasanthakumar Packiriswamy ◽  
Satheesha B Nayak
Keyword(s):  
Saphenous Vein ◽  
Lower Limb ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Femoral Vein ◽  
Saphenous Veins ◽  
Left Lower Limb ◽  
Male Cadaver ◽  
Complete Duplication ◽  
Femoral Triangle

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.

scholarly journals Variants of Localization and Extension of Hypo- and Aplasia of the Great Saphenous Vein in Patients with Primary Varicose Great Saphenous Veins

2019 ◽  
Vol 25 (2) ◽  
Author(s):  
Rostyslav Sabadosh
Keyword(s):  
Saphenous Vein ◽  
Lower Limb ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Lower Limbs ◽  
Ultrasound Scan ◽  
Saphenous Veins ◽  
Vein Segment ◽  
Surgical Tactics ◽  
The Relationship

The objective of the research was to improve the diagnostics and treatment of patients with primary varicose great saphenous veins by studying their frequency and systematizing the variants of localization and extension of great saphenous vein hypoplasia and aplasia in its trunk. Materials and Methods. The study included 560 patients with varicose veins of the lower limbs and pathological refluxes in different segments of the great saphenous vein. All the patients underwent triplex ultrasound scan of the lower limb venous system. Results. Among the patients with pathological reflux in a certain GSV segment, hypo- and aplasia of its segments were observed in 32.5% of the cases (95% CI 28.6-36.6%). Aplasia of this vein was observed twice as less frequently than hypoplasia (p<0.05). In 2.3% of the cases (95% CI 1.2-3.9%), hypoplasia of a certain GSV segment evolved to aplasia, or vice versa. It was found that the GSV trunk may have several hypo- or aplastic regions separated by its normal or varicose segment – bi-level hypo- or aplasia that was observed in 3.8% of the patients with hypo- or aplasia (95% CI 1.6-7.8%). In bi-level hypo- or aplasia, 2 hypoplastic regions were detected in 85.7% of the cases (95% CI 42.1-99.6%) and 2 aplastic regions were found in 14.3% of the cases (95% CI 0.4-57.9%). There were proposed to distinguish the following variants of GSV hypo- and aplasia: 1) simple: total, proximal, segmental and distal; 2) bi-level: proximal segmental, distal segmental and bi-segmental. In addition, for every dysplastic vein segment, the type of malformation should be indicated, namely hypoplasia, aplasia, or hypo/aplasia. Conclusions. The study conducted allowed assessing the relationship between the variants of GSV hypo- and aplastic segment localization and extension and different variations of pathological refluxes of the GSV in its trunk for further choice of surgical tactics.

Venous Reflux at the Sapheno-Femoral Junction

1995 ◽  
Vol 10 (4) ◽  
pp. 132-135 ◽  
Author(s):  
G. M. Somjen ◽  
J. Donlan ◽  
J. Hurse ◽  
J. Bartholomew ◽  
A. H. Johnston ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Ultrasound Examination ◽  
Varicose Veins ◽  
Femoral Vein ◽  
Duplex Ultrasound ◽  
Venous Reflux ◽  
Duplex Scan ◽  
Common Femoral Vein ◽  
Long Saphenous Vein ◽  
The Common

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.

Non-Invasive Methods of Measuring Venous Compliance

1992 ◽  
Vol 7 (2) ◽  
pp. 78-81 ◽  
Author(s):  
A. H. Davies ◽  
T. R. Magee ◽  
J. Hayward ◽  
R. Harris ◽  
R. N. Baird ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Duplex Ultrasound ◽  
Venous Occlusion ◽  
Qualitative Assessment ◽  
Venous Compliance ◽  
Non Invasive ◽  
Long Saphenous Vein ◽  
Saphenous Veins ◽  
Transit Times ◽  
The Mean

Objective: To compare two non-invasive methods of qualitative assessment of the long saphenous vein in terms of venous compliance. Design: Thirty-five long saphenous veins were examined. Compliance measurements have been calculated using: Method A in which an AV Impulse machine (Novamedix, UK) is used to generate a pulse wave in the long saphenous vein and the measurement of transit times are performed. Method B involves duplex ultrasound and venous occlusion of the long saphenous vein. Occlusive pressure measurements are used in both methods. Results: The mean vein compliance ratio measured in 35 long saphenous veins with the different methods was 0.23 (0.18–0.28) and 0.26 (0.22–0.30) using method A and B respectively. (Mean and (95% confidence interval)). The results show that a good correlation r = 0.91 and this was confirmed using methods of agreement. Conclusion: Both techniques give comparable results, however, the method involving Duplex is easier to perform. The research and clinical implications of these techniques remain to be assessed.

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