A potential therapeutic pitfall in the treatment of venous reflux due to variant planar anatomy of varicose segments

作者：Deniz Sinan; Tureli Derya^*; Akpinar Burcu; Oguzkurt Levent

来源：Phlebology, 2018, 33(7): 470-474.

DOI：10.1177/0268355517722703

• Great saphenous vein
• saphenous compartment
• ultrasonography
• variation

Purpose To elaborate on a planar anatomic variant of great saphenous vein as a potential therapeutic pitfall in the treatment of venous reflux.
Materials and methods Lower extremity veins in 568 limbs with great saphenous vein insufficiency were sonographically mapped. A rather overlooked variation, the saphenous bow, was studied with emphasis on anatomic clarification and its involvement in venous insufficiency.
Results This variation, observed in 5.1% (n=29) of limbs, comprised two segments; one uninterrupted great saphenous vein proper coursing throughout saphenous compartment and one extra-compartmental segment originating distally from and proximally fusing with it. Venous arch remains within compartment only briefly during take-off and re-entry. Extra-compartmental venous arch had reflux either alone (10.3%) or together with intra-compartmental segment (75.9%).
Conclusion This variation, part of saphenous segmental aplasia/hypoplasia complex, is associated with venous insufficiency. Meticulous mapping of great saphenous vein territory and identification of such variants during planning stage is indispensable for optimal clinical outcomes of treatment.

• 出版日期2018-8