Planning endovascular vein valve implantation: Significance of vein size variability

Abstract

Femoropopliteal veins demonstrated a wide range of diameters, and significant diameter changes were detected in all vein segments. Variations in vein diameter must be evaluated in candidates for endovascular venous valve prostheses. Such devices must adapt to a wide range in vein diameter.

The femoral vein diameter and its correlation with sex, age and body mass index – An anatomical parameter with clinical relevance

“…Basically, the FVD can be used to estimate the central venous pressure (CVP), 1 but it is also an important predictor of chronic venous insufficiency (CVI) 2,3 and a critical factor when assessing endoprosthetic valve size for CVI treatment. 4,5 Besides deep venous thrombosis (DVT), dilation of the deep venous system might also play an important role for CVI-causing valve dysfunction. Interestingly, the body mass index (BMI) seems to correlate with an increased diameter of the femoral vein (FV) [6][7][8][9][10] which in turn marks adipositas as a potential factor in the development of venous valve dysfunction due to phlebotic dilation.…”

Avaliação do segmento venoso femoropoplíteo pela ultrassonografia Doppler em pacientes com úlcera varicosa

“…Salles-Cunha et al studied the changes in FPS diameter to plan the placement of an endovascular vein valve and found values of 8.4 mm to 9.7 mm for PV with venous hypertension due to valve insufficient. They classified their results as fundamentally important for the planning of this type of treatment 44 .…”

Human Femoral Vein Diameter and Topography of Valves and Tributaries: A Post Mortem Analysis

“…It was previously shown that the femoral vein dilates by 21-34% on average during exercise and can dilate by up to 100% in some individuals (Mortensen et al, 1990;Jeanneret et al, 1999;Fronek et al, 2001;Salles-Cunha et al, 2003;Keiler et al, 2018). Overall, the mean FVDs in our study are in accordance with previous in vivo studies based on B-mode sonography and are mostly consistent with in vivo values measured in subjects supine and/or at rest (Bulitta et al, 1996;Hertzberg et al, 1997;Dyszynski et al, 1999;Fronek et al, 2001;Salles-Cunha et al, 2003;Nagahiro et al, 2007;Dyszynska, 2008;van Rij et al, 2008;Cho et al, 2016) (Table 3). Since in our study the tissues were fixed with the corpses supine and perfused via a femoro-arterial access, the FVs were scarcely affected by dilation.…”

“…There have been few detailed studies of the topographic pattern of femoral vein (FV) tributaries (Mühlberger et al, 2008;Mühlberger, 2011) and valves (Leu et al, 1979;Moore et al, 2011), which are crucial for identifying optimal implant locations. Conversely, the femoral vein diameter (FVD) is critical in regard to hemodynamic performance and venous wall stress when endoprosthetic valve size is assessed (Salles-Cunha et al, 2003;Tien et al, 2017). Several studies using in vivo sonographic measurements have contributed to our knowledge of the adult FVD (Bulitta et al, 1996;Hertzberg et al, 1997;Dyszynski et al, 1999;Jeanneret et al, 1999;Fronek et al, 2001;Kröger et al, 2003;Salles-Cunha et al, 2003;van Rij et al, 2008;Dyszynska, 2008;Willenberg et al, 2010;Cho et al, 2016;Keiler et al, 2018).…”