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

Abstract

Background The femoral vein diameter is a critical factor when assessing endoprosthetic valve size for the treatment of chronic venous insufficiency. To examine the previously stated correlation between body mass index and femoral vein diameter and to re-assess the anatomical and physiological demands for a valve implant for chronic venous insufficiency treatment, we measured the femoral vein diameter in 82 subjects. Method Femoral vein diameters (164 legs) were measured with B-mode sonography both in supine position at rest and in upright position during Valsalva maneuver. Result The mean femoral vein diameter differed significantly between supine position (13.6 ± 3.0 mm) and upright position (16.4 ± 2.6 mm). Males possessed a significant bigger diameter than females. A significant positive correlation between femoral vein diameter and body mass index was observed. Conclusion Assuming an increased femoral vein diameter due to obesity would further impair valve functionality by increasing distance between both valve cusps. For the development of artificial venous valves, it is crucial to consider patient- and condition-dependent vein dilation.

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

“…The relationship between age and FVD is possibly a differential multi‐level correlation. Recent sonographical data suggest a significant difference in FVD between younger (< 30 years) and older subjects (Keiler et al, ). This trend toward a greater FVD seems to reverse in older subjects (> 60 years) both in vivo (Fronek et al, ) and in our present post mortem data.…”

“…In general, BMI differences between different age cohorts could contribute to the age/FVD correlation since previous in vivo studies have demonstrated a positive correlation between FVD and BMI (Jeanneret et al, ; Fronek et al, ; Kröger et al, ; van Rij et al, ; Willenberg et al, ; Keiler et al, ) and epidemiological studies have demonstrated a distinct BMI increase between 25 years and 50 years age groups in the general population (Gostynski et al, ). On average, BMI more or less stagnates at older ages, though data for age > 65 years are lacking.…”

“…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).…”

“…* = slightly significant (0.01 < P ≤ 0.05), ** = significant (0.001 < P ≤ 0.01), *** = highly significant (P ≤ 0.001). positive correlation between FVD and BMI (Jeanneret et al, 1999;Fronek et al, 2001;Kröger et al, 2003;van Rij et al, 2008;Willenberg et al, 2010;Keiler et al, 2018) and epidemiological studies have demonstrated a distinct BMI increase between 25 years and 50 years age groups in the general population (Gostynski et al, 2004). On average, BMI more or less stagnates at older ages, though data for age > 65 years are lacking.…”

“…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, ; Tien et al, ). Several studies using in vivo sonographic measurements have contributed to our knowledge of the adult FVD (Bulitta et al, ; Hertzberg et al, ; Dyszynski et al, ; Jeanneret et al, ; Fronek et al, ; Kröger et al, ; Salles‐Cunha et al, ; van Rij et al, ; Dyszynska, ; Willenberg et al, ; Cho et al, ; Keiler et al, ). To our knowledge, there have been no post mortem studies of the FVD.…”