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Safenofemoral bileşke düzeyi major süperfisiyal ven varyasyonları; ultrasonografi yöntemi ile değerlendirilmesi

Year 2019, Volume: 11 Issue: 3, 277 - 282, 01.09.2019
https://doi.org/10.21601/ortadogutipdergisi.460162

Abstract

Amaç: Bu çalışmanın amacı varis tedavisinde oldukça önemli bir bölge olan safenofemoral bileşke düzeyinin yüzeyel venöz vasküler anatomik varyasyonlarının ultrasonografi ile ortaya konulmasıdır.
Gereç ve Yöntem: Hastanemiz radyoloji bölümüne Şubat 2017 – Temmuz 2018 tarihleri arasında venöz yetmezlik ön tanısıyla yönlendirilen 79 hasta çalışmaya dâhil edildi ve toplam 158 safenofemoral bölge venöz vasküler anatomisi B-mod ve renkli doppler ultrasonografi ile değerlendirdi. Safenofemoral bölge yüzeyel venöz vasküler anatomisi detaylı olarak incelendi, Glasser ve Daseler anatomik sınıflandırmalarına göre sınıflandırıldı ve varyasyon sıklıkları hesaplandı.
Bulgular: Çalışmamızda Glasser sınıflandırmasına göre en sık görülen grup 30 (%19) safenofemoral bölgede izlenen tip 2C olurken, bunu tip 2B ve 2C takip etti. Daseler sınıflandırmasına göre en sık izlenen safenofemoral bölge varyasyonu tip H (VIII) olurken bunu tip F (VI) ve tip E (V) takip etti. Safenofemoral bileşke düzeyinde safena magnaya açılan süperfisiyal venöz dal sayıları değerlendirildiğinde, 1 ile 5 arasında süperfisiyal venöz dalın açıldığı izlendi. Bunlardan en sık 78 (%49) olguda izlenen üç venöz dalın açıldığı tespit edildi. Bunu sırasıyla iki venöz dalın açıldığı 50 (%32) olgu, dört venöz dalın açıldığı 25 (%16) olgu, bir venöz dalın açıldığı 3 (%2) olgu ve beş venöz dalın açıldığı 1 (%1) olgu takip etti.
Sonuç: Safenofemoral bileşke düzeyinde major süperfisiyal venöz yapıların ayrıntılı anatomisinin ultrasonografi ile ortaya konulması, variköz venlerin etiyopatogenezinin ayrıntılı bir şekilde ortaya konmasına yardımcı olmasının yanı sıra selektif tedavi planlanmasına ve dolayısıyla tedavi sonuçlarına katkı sağlayacağı kanaatindeyiz.

References

  • Hollinshead WH. Anatomy for Surgeons. The Back and Limbs. Volume 3. 3rd edition. Harper & Row.Philadelphia. 1992. P.607-10.
  • Standring S. Gray’s Anatomy. 39th edition. Elsevier Churchill Livingstone; London: 2005. P. 1452-3.
  • Woodburne RT. Essentials of Human Anatomy. London: Oxford University Press; 1961: 499-510.
  • Moore KL. Clinically Oriented Anatomy. Philadelphia: Williams and Wilkins; 1980: 485-95.
  • George Arthur Piersol’s Human Anatomy. Front of thigh. Philadelphia: J.B.Lippincott Company; 1936:784-99.
  • Morris Human Anatomy. Eleventh edition; Newyork: The Blakistandivision/McGraw-Hill Book Company; 1942: 687-99.
  • Mansberger AR, Yeager GH, Smeleser RM, Brumback FM. Sapheno-femoral junction anomalies. Surgery, Gynaecol Obstetr 1950; 91: 533-6.
  • Corrales NE, Irvine A, McGuinnes CL, Dourado R, Burnard KG. Incidence and pattern of long saphenous vein duplication and its possible implications for recurrence after varicose vein surgery. Br J Surg 2002; 89: 323–6.
  • Janowski K, Topol M. Types of outlet of the major saphenous vein tributaries in patients with chronic vein insufficiency of the lower limbs. Folia Morphol 2004; 63: 473-9.
  • Orsini A, Molfetta S, Pagani C. The importance of anatomical variants of the sapheno-femoral junction in lower limb varicose vein surgery. Minerva Cardioangiol 2001; 49: 257–62.
  • Glasser ST. Variations of the saphena magna at the sapheno femoral junction. Anat Rec 1942; 82: 289-95.
  • Daseler EH, Anson BJ, Reimann AF. The saphenous venous tributaries and related structures in relation to technique of high ligation. Surgery, Gynecol Obstetr 1946; 82: 53.
  • Garner JP, Heppell PSJ, Leopold PW. The lateral accessory saphenous vein-a common cause of recurrent varicose veins. Annals of the Royal College of Surgeons of England 2003; 85: 389.
  • Chun MH, Han SH, Chung JW, ve ark. Anatomical observation on draining patterns of saphenous tributaries in Korean adults. JKMS 1992; 7: 25–33.
  • Mühlberger D, Morandini L, Brenner E. Venous valves and major superficial tributary veins near the saphenofemoral junction. J Vascular Surg 2009; 49: 1562-9.
  • Janowski K, Topol M. Types of outlet of the major saphenous vein tributaries in patients with chronic vein insufficiency of the lower limbs. Folia Morphologica 2014; 63: 473-9.
  • Lee DK, Ahn KS, Kang CH, Cho SB. Ultrasonography of the lower extremity veins: anatomy and basic approach, Ultrasonography 2017; 36: 120-30.
  • Mendoza E. The saphenofemoral junction in ultrasound. Phlebologie 2014; 43: 42-5.
  • Nesbitt C, Bedenis R, Bhattacharya V, Stansby G. Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus open surgery for great saphenous vein varices. Cochrane Database of Systematic Reviews 2014; 30: 7.

Saphenofemoral region major superficial vein variations; evaluated by ultrasonography technique

Year 2019, Volume: 11 Issue: 3, 277 - 282, 01.09.2019
https://doi.org/10.21601/ortadogutipdergisi.460162

Abstract

Aim: The purpose of this study is to present superficial venous vascular anatomic variations of the saphenofemoral junction, which is a very important region in variceal treatment, by ultrasonography technique.
Material and Method: Seventy nine patients who were referred to our radiology department and pre-diagnosed for venous insufficiency between February 2017 and July 2018 were included in the study and a total number of 158 venous vascular anatomy of saphenofemoral regions were evaluated by B- mode and color doppler ultrasonography. The superficial venous vascular anatomy of the saphenofemoral regions were evaluated in detail, classified according to the anatomical classifications of Glasser and Daseler, and the frequencies of variations were calculated.
Results: In our study, the most common group according to the Glasser classification was type 2C observed in 30 (19%) saphenofemoral regions followed by type 2B and 2C. Type H (VIII) was the most common type of saphenofemoral region according to the Daseler classification followed by Type F (VI) and type E (V). Between 1 to 5 superficial venous branches draining to saphena magna were observed at the level of saphenofemoral junction. Three venous branches draining to the saphena magna were observed in 78 (49%) saphenofemoral junctions followed by two venous branches in 50 (32%) saphenofemoral junctions, four venous branches in 25 (16%) saphenofemoral junctions, one venous branch in 3 (2%) saphenofemoral junctions and five venous branches in 1 (1%) saphenofemoral junction, respectively.
Conclusion: We think the assessment of the detailed anatomy of the major superficial venous structures at the level of the saphenofemoral junction by doppler ultrasonography will help to elucidate the etiopathogenesis of the varicose veins as well as contribute to the selective treatment planning and consequently the treatment results.

References

  • Hollinshead WH. Anatomy for Surgeons. The Back and Limbs. Volume 3. 3rd edition. Harper & Row.Philadelphia. 1992. P.607-10.
  • Standring S. Gray’s Anatomy. 39th edition. Elsevier Churchill Livingstone; London: 2005. P. 1452-3.
  • Woodburne RT. Essentials of Human Anatomy. London: Oxford University Press; 1961: 499-510.
  • Moore KL. Clinically Oriented Anatomy. Philadelphia: Williams and Wilkins; 1980: 485-95.
  • George Arthur Piersol’s Human Anatomy. Front of thigh. Philadelphia: J.B.Lippincott Company; 1936:784-99.
  • Morris Human Anatomy. Eleventh edition; Newyork: The Blakistandivision/McGraw-Hill Book Company; 1942: 687-99.
  • Mansberger AR, Yeager GH, Smeleser RM, Brumback FM. Sapheno-femoral junction anomalies. Surgery, Gynaecol Obstetr 1950; 91: 533-6.
  • Corrales NE, Irvine A, McGuinnes CL, Dourado R, Burnard KG. Incidence and pattern of long saphenous vein duplication and its possible implications for recurrence after varicose vein surgery. Br J Surg 2002; 89: 323–6.
  • Janowski K, Topol M. Types of outlet of the major saphenous vein tributaries in patients with chronic vein insufficiency of the lower limbs. Folia Morphol 2004; 63: 473-9.
  • Orsini A, Molfetta S, Pagani C. The importance of anatomical variants of the sapheno-femoral junction in lower limb varicose vein surgery. Minerva Cardioangiol 2001; 49: 257–62.
  • Glasser ST. Variations of the saphena magna at the sapheno femoral junction. Anat Rec 1942; 82: 289-95.
  • Daseler EH, Anson BJ, Reimann AF. The saphenous venous tributaries and related structures in relation to technique of high ligation. Surgery, Gynecol Obstetr 1946; 82: 53.
  • Garner JP, Heppell PSJ, Leopold PW. The lateral accessory saphenous vein-a common cause of recurrent varicose veins. Annals of the Royal College of Surgeons of England 2003; 85: 389.
  • Chun MH, Han SH, Chung JW, ve ark. Anatomical observation on draining patterns of saphenous tributaries in Korean adults. JKMS 1992; 7: 25–33.
  • Mühlberger D, Morandini L, Brenner E. Venous valves and major superficial tributary veins near the saphenofemoral junction. J Vascular Surg 2009; 49: 1562-9.
  • Janowski K, Topol M. Types of outlet of the major saphenous vein tributaries in patients with chronic vein insufficiency of the lower limbs. Folia Morphologica 2014; 63: 473-9.
  • Lee DK, Ahn KS, Kang CH, Cho SB. Ultrasonography of the lower extremity veins: anatomy and basic approach, Ultrasonography 2017; 36: 120-30.
  • Mendoza E. The saphenofemoral junction in ultrasound. Phlebologie 2014; 43: 42-5.
  • Nesbitt C, Bedenis R, Bhattacharya V, Stansby G. Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus open surgery for great saphenous vein varices. Cochrane Database of Systematic Reviews 2014; 30: 7.
There are 19 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original article
Authors

Adnan Özdemir This is me 0000-0003-0652-5396

Yunus Yılmazsoy 0000-0001-7293-2059

Serdar Arslan 0000-0001-7984-4326

Publication Date September 1, 2019
Published in Issue Year 2019 Volume: 11 Issue: 3

Cite

Vancouver Özdemir A, Yılmazsoy Y, Arslan S. Safenofemoral bileşke düzeyi major süperfisiyal ven varyasyonları; ultrasonografi yöntemi ile değerlendirilmesi. omj. 2019;11(3):277-82.

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