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2004 | 63 | 4 |

Tytuł artykułu

Types of outlet of the major saphenous vein tributaries in patients with chronic vein insufficiency of the lower limbs

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Warianty tytułu

Języki publikacji

EN

Abstrakty

EN
Chronic vein insufficiency (CVI) is a disease which, when it develops, leads to varicose veins of the lower limbs. As approximately 25% to 50% of people suffer from it, it should be recognised as a public disease. The treatment of chronic vein insufficiency is based on a surgical approach. The aim of the operation is to remove (strip) the insufficient major saphenous vein (MSV), the main cause of the disease. The major saphenous vein drains into the femoral vein and forms the sapheno-femoral junction, which is located in the hiatus saphenous within the femoral triangle. We conducted 94 varicose vein operations by the Babcock method on patients suffering from chronic vein insufficiency. This surgical treatment was performed in “Therapy”, a private clinic for peripheral vessel disease. We operated on 52 left lower limbs and 42 right lower limbs. The patients were qualified for the operation procedure after physical examination and Doppler ultrasonography imaging. We identified 5 types of major saphenous vein tributary drainage. The most common was Type I, in which there were 3 tributaries draining directly into the major saphenous vein. This type consisted of 45 cases (47.87%). We distinguished here 3 modifications. In Type II, however, there were 4 direct tributaries that drained into the major saphenous vein in 23 cases (24.46%). In this group of patients also 3 modifications were distinguished. Type III occurred in 14 cases (14.89%). We identified here 2 direct tributaries that drained into the saphenous vein and divided this type into 2 modifications. Type IV occurred in 8 cases (8.51%). Here we found 5 or 6 direct tributaries depending on the number of the external pudendal veins. Type V turned out to be very rare, occurring in only 4 cases (4.25%). Among all the types mentioned a thin tributary 1–2 mm wide was found in 10 cases (10.63%). This ran from under the fascia cribrosa into the saphenofemoral junction in the hiatus saphenous. This may be one of the causes of the recurrences of chronic vein insufficiency. There is also the possibility that a tributary will be overlooked or ignored during the operation, particularly when Type IV appears with 5 or 6 direct collaterals.

Wydawca

-

Czasopismo

Rocznik

Tom

63

Numer

4

Opis fizyczny

p.473-479,fig.,ref.

Twórcy

autor
  • Medical University, G.Narutowicza 60, 90-136 Lodz, Poland
autor

Bibliografia

  • 1. Bruska M, Woźniak W (1996) Connections between the great saphenous vein and cutaneus veins of the thigh in human fetuses. Folia Morphol, 55: 222–223.
  • 2. Chun MH, Han SH, Chung JW, Cho SS, Ko JS, Chung IH, Chung GB, Lee MS, Kang HS, Park SS (1992) Anatomical observation on draining patterns of saphenous tributaries in Korean adults. JKMS, 7: 25–33.
  • 3. Corrales NE, Irvine A, McGuinnes CL, Dourado R, Burnard KG (2002) Incidence and pattern of long saphenous vein duplication and its possible implications for recurrence after varicose vein surgery. Br J Surg, 89: 323–326.
  • 4. Glasser ST (1943) An anatomic study of venous variations at the fossa ovalis. Arch Surg, 46: 289–295.
  • 5. Gillot C (1997) Superficial veins of the lower limbs. Ann Chir, 57: 713–727.
  • 6. Hilty H (1955) Die makroskopische Gefassvariabilitat in Mundungsgebiet der vena saphena magna des Menschen. Basel, 1955: 1–148.
  • 7. Kocoń T, Żebrowski W (1973) Liczba i ukształtowanie dopływów końcowego odcinka żyły odpiszczelowej. Przegl Chir, 12: 1397–1402.
  • 8. Lefebvre-Vilardebo M (1991) The sapheno-femoral area: anatomic study and concepts for the prevention of varicose recurrences. J Mal Vasc, 16: 355–358.
  • 9. Nabatoff RA (1981) Anomalies encountered during varicose vein surgery. Phlebologie, 34: 21–27.
  • 10. Orsini A, Molfetta S, Pagani C (2001) The importance of anatomical variants of the sapheno-femoral junction in lower limb varicose vein surgery. Minerva Cardioangiol, 49: 257–262.
  • 11. Szyber P, Rybak Z (1993) Historia naturalna operacyjnego leczenia żylaków kończyn dolnych. Przegl Flebol, 1: 62–68.
  • 12. Viani MP, Poggi RV, Pinto A, Andreani SM, Spagnoli C, Maruotti RA (1996) Re-exploration of the saphenofemoral junction in the treatment of recurrent varicose veins. Int Surg, 81: 382–384.
  • 13. Wienert V (1993) Epidemiologie et socio-economie des maladies veineuses en Allemagne. Phlebologie, 46: 225.

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Bibliografia

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