scholarly journals CLINICAL ANATOMY OF THE PERFORATING VEINS OFTHE PROXIMAL LOWER LIMBS

2021 ◽  
Vol 29 (1) ◽  
pp. 28-37
Author(s):  
R.E. Kalinin ◽  
◽  
I.A. Suchkov ◽  
I.N. Shanaev ◽  
A.A. Nekliudov ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Femoral Vein ◽  
Physical Exertion ◽  
Superficial Femoral Vein ◽  
Perforating Veins ◽  
Great Vessels ◽  
First Time ◽  
Upper Third ◽  
Arterial Branch

Objective. To clarify the topographic and anatomical feature of the perforating veins (PVs) in the proximal part of the lower extremity. Methods. 70 amputated lower extremities from the patients with severe ischemia were subjected to sectional anatomical study; 2800 patients with varicose disease underwent lower extremity sonography. Results. PVs were primarily located on the medial surface of the thigh. In the upper third of the thigh PVs drain into superficial femoral vein. It was detected that one or two PVs occur sin the lower third of the hip draining into superficial femoral vein and originating from the great saphenous vein in 73.6% cases. All PVs were accompanied by an arterial branch from the superficial femoral artery. Anatomical sectional study revealed that a nervous branch accompanied PVs in the lower third of the thigh. Two or four PVs were detected on the lateral surface of the thigh. PVs in the popliteal fossa could be referred to as “atypical” due to their rare occurence (0.4% of cases at sonography) in combination with absent typical sapheno-popliteal junction. PVs in this area were not supported by the intermuscular septa. PVs drained laterally into popliteal vein of the lower limb in 100% cases, while small saphenous vein drained into great saphenous vein in the upper third of the leg or into the intersaphenous vein. Conclusion. Perforating veins constitute perforating bundles (PV, arterial branch, nervous branch), which are predominantly located along the intermuscular septa, which create a constant and strong orientation along the direction of the great vessels. This ensures stable hemodynamics of great vessels and perforating complexes and does not allow squeezed tham togeter during physical exertion. What this paper adds For the first time it has been proved that the perforating veins of the gluteal region pass through the fascia and the thickness of the gluteus maximus muscle and enter the superior and inferior gluteal veins, being transmuscular perforating veins. For the first time it has been established that the location of the femoral perforating veins along the intermuscular septa allows preserving the hemodynamics of the perforating complexes without any squeezed in physical exertion.

Morphometric characteristics of competent proximal valves of the great saphenous vein and superficial femoral vein in vivo according to ultrasound angioscanning data

2019 ◽  
Vol 18 (3) ◽  
pp. 16-22
Author(s):  
E. K. Gavrilov ◽  
H. L. Bolotokov ◽  
E. A. Babinets
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Femoral Vein ◽  
Lower Boundary ◽  
Average Diameter ◽  
Lower Limbs ◽  
Functional Test ◽  
Natural Form ◽  
Superficial Femoral Vein ◽  
Venous Diameter

Introduction. It seems relevant to study the ultrasound anatomy and physiology of the proximal valve segments of the superficial femoral vein (SFV) and the great saphenous vein (GSV) to develop effective reconstructive surgical interventions on venous valves in chronic vein diseases.The aim of the survey was to study the ultrasound anatomy of the venous wall, the size and shape of the proximal SFV and GSV valves are normal at rest and during the functional test Valsalva.Material and methods. Proximal valve SFV studies were performed in 144 lower limbs in 115 people (mean age 51.1 ± 14.4 years, 60 women and 55 men), proximal GSV valves studies - in 82 lower limbs in 67 persons (average age 45, 1 ± 13.3 years, 33 women, 34 men). A longitudinal and transverse ultrasound scanning of the femoral vein bifurcation and safenofemoral junction areas were performed, the structures of the proximal SFV and GSV valves were visualized, the valve shape was measured and the diameter of the veins was measured at the level valves at the base of the valves (inlet diameter), at the point of maximum ectasia (diameter of ectasia), at the upper border of the valve (diameter of the outlet), as well as measuring the length of the valve a (length to ectasia, the total length of the valve). The degree of ectasia over the valve was judged by calculating the relative venous diameter change (RVDC).Results. the average diameter of the SFV at the level of the lower boundary of its first valve was 10.01 ± 1.44 mm. The average diameter of the SFV at the level of the maximum ectasia of its first valve was 13,1±2 mm. The average value of the index of RVDC for SFV was 31%±10,4%. An increase in the diameter of the vein in the zone of supravalvular ectasia up to 20% corresponded to the spindle-shaped valve, more than 20% - to the clavate form, which was noted in the majority of the examined. The change in the relative venous diameter of the SFV on the Valsalva test was 38,2%±12,4%. The average diameter of the GSV at the base of the first valves was 6,07±1,25 mm. The average diameter of the GSV at the level of the maximum ectasia of the osteal valve was 9,44±1,69 mm. The average RVDC for GSV was 58%±24%.Conclusion. the natural form of proximal SFV and GSV valves is clavate with presence of the significant supravalvular ectasia, which was noted in the majority of the subjects alone and in all during the performance of the Valsalva functional test.

scholarly journals ANATOMICAL MEASUREMENTS OF GREAT SAPHENOUS VEIN AND SUPERFICIAL FEMORAL VEIN BY COLORED DUPLEX ULTRASOUND.

2018 ◽  
Vol 6 (2) ◽  
pp. 1012-1020
Author(s):  
IbrahimA Maher ◽  
◽  
HosamA Tawfik ◽  
IbrahimHEl Azzony ◽  
NearmeenM Rashad ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Femoral Vein ◽  
Duplex Ultrasound ◽  
Superficial Femoral Vein

Neovascularization in Restoration of Continuity of the Rat Femoral Vein following Surgical Interruption

1987 ◽  
Vol 2 (1) ◽  
pp. 1-5 ◽  
Author(s):  
G.M. Glass
Keyword(s):  
Surgical Treatment ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Femoral Vein ◽  
Histological Studies ◽  
Venous Circulation ◽  
Main Vein

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.

Anatomy of the lymph node venous networks of the groin and their investigation by ultrasonography

2015 ◽  
Vol 31 (5) ◽  
pp. 334-343 ◽  
Author(s):  
Jean Francois Uhl ◽  
Miguel Lo Vuolo ◽  
Nicos Labropoulos
Keyword(s):  
Lymph Node ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Femoral Vein ◽  
Normal Subjects ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Anatomical Dissection ◽  
Anatomical Finding

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.

scholarly journals Factors Associated with Recurrence of Varicose Veins after Thermal Ablation: Results of The Recurrent Veins after Thermal Ablation Study

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
R. G. Bush ◽  
P. Bush ◽  
J. Flanagan ◽  
R. Fritz ◽  
T. Gueldner ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Varicose Vein ◽  
Thermal Ablation ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Time Frame ◽  
Factors Associated ◽  
Perforating Veins ◽  
Contributory Factors ◽  
Ablation Study

Background. The goal of this retrospective cohort study (REVATA) was to determine the site, source, and contributory factors of varicose vein recurrence after radiofrequency (RF) and laser ablation.Methods. Seven centers enrolled patients into the study over a 1-year period. All patients underwent previous thermal ablation of the great saphenous vein (GSV), small saphenous vein (SSV), or anterior accessory great saphenous vein (AAGSV). From a specific designed study tool, the etiology of recurrence was identified.Results. 2,380 patients were evaluated during this time frame. A total of 164 patients had varicose vein recurrence at a median of 3 years. GSV ablation was the initial treatment in 159 patients (RF: 33, laser: 126, 52 of these patients had either SSV or AAGSV ablation concurrently). Total or partial GSV recanalization occurred in 47 patients. New AAGSV reflux occurred in 40 patients, and new SSV reflux occurred in 24 patients. Perforator pathology was present in 64% of patients.Conclusion. Recurrence of varicose veins occurred at a median of 3 years after procedure. The four most important factors associated with recurrent veins included perforating veins, recanalized GSV, new AAGSV reflux, and new SSV reflux in decreasing frequency. Patients who underwent RF treatment had a statistically higher rate of recanalization than those treated with laser.

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.

The condition of the veins of the femoral-iliac segment in patients with varicose veins of the lower extremities

1982 ◽  
Vol 63 (4) ◽  
pp. 63-66
Author(s):  
V. E. Mamaev ◽  
M. F. Musin ◽  
M. N. Malinovsky
Keyword(s):  
Contrast Agent ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Femoral Vein ◽  
Lower Extremities ◽  
The State ◽  
Contrast Study ◽  
Aneurysmal Dilatation ◽  
Saphenous Veins

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

Perforator vein endovenous heat induced thrombosis after laser ablation of the great saphenous vein

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 330-332
Author(s):  
Heiko Uthoff ◽  
Hong H. Keo ◽  
Luca Spinedi ◽  
Daniel Staub
Keyword(s):  
Laser Ablation ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Femoral Vein ◽  
Endovenous Laser Ablation

Summary: Endovenous heat induced thrombosis at the sapheno-femoral or sapheno-popliteal junction is a well-known complication after superficial truncal vein endovenous laser ablation (EVLA). This report describes a rare thigh perforator vein thrombus propagation into the femoral vein after EVLA of the great saphenous vein.

Minor tributary veins of the common femoral vein near the saphenofemoral junction – A postmortem study

2020 ◽  
Vol 35 (10) ◽  
pp. 792-798
Author(s):  
Dominic Mühlberger ◽  
Achim Mumme ◽  
Markus Stücker ◽  
Erich Brenner ◽  
Thomas Hummel
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Femoral Vein ◽  
Ex Situ ◽  
Common Source ◽  
Vast Number ◽  
Common Femoral Vein ◽  
The Common ◽  
Saphenofemoral Junction

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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