Intra-Operative Phlebography of the Short Saphenous Vein

Abstract

The short saphenous vein is more and more often held responsible for the onset and development of varicose conditions and post-operative recurrence. In order to perform complete posterior saphenectomy account must be taken of the frequent anatomical variations in the outflow of this vein. A method of intra-operative phlebography of the short saphenous vein has been developed. The results confirm the high rate of the anatomical variations. Intra-operative phlebography facilitates complete posterior saphenectomy without negative effects in terms of surgical trauma and cosmetic results, thanks to the new technical developments.

The impact of isolated lesser saphenous vein system incompetence on clinical signs and symptoms of chronic venous disease

“…The previous findings indicate that as many other reports have suggested that CFDS should be performed before intervention. [3][4][5][6][7][8][9][10][11]13,33,38…”

“…The LSV has variable anatomy and connects with the greater saphenous vein (GSV), the deep veins, and the muscular vein at various levels. [1][2][3][4][5][6][7][8][9][10] After the elegant work of Giacomini 1 in 1873 and Kosinski 2 in 1926 performing cadaveric dissections of the LSV, subsequent phlebographic and duplex scanning studies enhanced our knowledge of the anatomy and function of this system. [3][4][5][6][7][8][9][10] Despite the numerous reports on the LSV, the complex anatomy and insufficient knowledge of many physicians who treated these veins have led to high rates of recurrent or residual varicosities.…”

“…[1][2][3][4][5][6][7][8][9][10] After the elegant work of Giacomini 1 in 1873 and Kosinski 2 in 1926 performing cadaveric dissections of the LSV, subsequent phlebographic and duplex scanning studies enhanced our knowledge of the anatomy and function of this system. [3][4][5][6][7][8][9][10] Despite the numerous reports on the LSV, the complex anatomy and insufficient knowledge of many physicians who treated these veins have led to high rates of recurrent or residual varicosities. [11][12][13] Incompetence of the LSV system has been associated with the entire spectrum of signs and symptoms of chronic venous disease (CVD), including ulceration.…”

Prevalence, anatomic patterns, valvular competence, and clinical significance of the Giacomini vein

“…7,12 Knowledge of the level of SSV termination is crucial clinically, because it enables its definitive ablation in patients undergoing surgery for SSV incompetence, thus ensuring a favorable clinical outcome in the long term. 3,5,6,8,11,[14][15][16][17][18][19][20][21][22] Irrespective of the SSV termination, a large SSV tributary or the SSV itself may project into the posterior thigh, coursing well above the apex of the popliteal space. Designated the Giacomini vein, 6,[8][9][10][11][22][23][24][25][26][27][28] after the investigator who first described it in 1873, 1 its prevalence is grossly understated among clinicians, and although its anatomic distribution has been described, 1,2,15,19,[27][28][29][30] its clinical value continues to be mostly undetermined.…”

“…This crosssectional controlled study examined the prevalence, anatomy, competency status, and clinical significance of the Giacomini vein in normal limbs (control group) and in limbs with different grades of chronic venous disease (CVD), stratified according to the CEAP classification. 31 These features of the Giacomini vein are correlated with the anatomic type of SSV termination itself, and are discussed in light of the available literature [1][2][3]5,6,[8][9][10][11][12][13][14][15]18,[20][21][22][23][24][25][26][27][28][29][30][32][33][34][35] (Table I).…”