Variable Venous Anatomy of the Popliteal Fossa Demonstrated by Duplex Scanning

Farrah, J.; Saharay, M.; Georgiannos, Stephen N.; Scurr, J. H.; Smith, Philip

doi:10.1111/j.1524-4725.1998.tb04271.x

Cited by 21 publications

(20 citation statements)

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“…6 Most UK vascular surgeons (89% in a recent questionnaire study) employ routine diagnostic imaging before SSV surgery because of the difficulty assessing this area by hand-held Doppler, and the variable anatomy of veins in the popliteal fossa. 7,8 Preoperative duplex marking of the SPJ was done selectively, according to the result of the diagnostic scan by surgeons in the present study, as mirrored by national data. 9 As in other studies, preoperative duplex marking of the SPJ has not been shown to improve outcomes.…”

Section: Discussionmentioning

confidence: 99%

A prospective evaluation of the outcome after small saphenous varicose vein surgery with one-year follow-up

O’Hare

Vandenbroeck

Whitman

et al. 2008

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

A prospective evaluation of the outcome after small saphenous varicose vein surgery with one-year follow-up

O’Hare

Vandenbroeck

Whitman

et al. 2008

Journal of Vascular Surgery

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“…[25][26][27] At the same time, SSV present a wide variability of anatomical junctions with the deep system: a fact that could influence its hemodynamics. 28 FV and PV belong to an intriguing anatomical site, whose valves' presence and location variability could represent a clue for this result explanation. 29,30 In fact, together with their anatomical variable distribution, valvular regions present potential confounding factors in the haemodynamics analysis, also due to the flow acceleration through the leaflets tract narrowing and to the valvular pockets turbulence.…”

Section: Discussionmentioning

confidence: 88%

Lower limbs venous kinetics and consequent impact on drainage direction

et al. 2017

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Background Literature concerning the lower limbs physiological venous haemodynamics is still lacking of reference velocity values and consequent impact on drainage direction. Aim of the present study is to assess the flow velocities in the different venous compartments, evaluating the possible Venturi effect role, thus finding clues for the identification of the physical model governing the flow direction. Methods Thirty-six lower limbs underwent a velocity and diameters echo-color-Doppler assessment in several anatomical point of analysis along both the deep and superficial venous systems. The investigation protocol included and compared two different manoeuvres to elicit the flow: manual calf compression/relaxation (CR) and active foot dorsiflexion (AFD). Both peak systolic (PSV) and time average velocities (TAV) were measured. Results The different venous segments demonstrated an overlap among the velocity values and the anatomical subdivision of the deep and superficial compartments. At the CR, TAV was 34 ± 12 cm/s in the deep venous system (N1), 15 ± 7 cm/s in the saphenous system (N2), 5 ± 2 cm/s in the saphenous tributaries (N3); PSV was 89 ± 35 cm/s in N1, 34 ± 16 cm/s in N2, 11 ± 4 cm/s in N3, p < 0.05. At the AFD, TAV was 33 ± 13 cm/s in N1, 15 ± 7 in N2, 9 ± 5 in N3; PSV was 83 ± 35 in N1, 32 ± 17 in N2, 15 ± 4 in N3, p < 0.05. A diameter decrease was reported from N1 to N3 ( p < 0.05). Conclusion This investigation provides evidences of the velocity decrease from the deepest to the most superficial compartments. These data introduce the Venturi effect as potential factor in the flow aspiration from the tributary to the deeper veins. The reported data represent a first step towards an objective evaluation of the physic laws governing the drainage. These values can constitute the basis for further investigations in pathological and post-procedural scenarios.

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“…Dilatation und/oderp athologische Strömungsumkehrd es Blutes (Reflux) in den Gastrocnemiusvenenk onnten vonm ehre-renA utoren in einemu nterschiedlichem Ausmaß bei Va rikosepatientensowohl mittels derP hlebographie (7,35), (farb)-duplex-sonographisch (1,2,4,6,9,21,22,33), alsa uchd urcha natomische Präparation (16) undi mR ahmenc hirurgischerI nterventionen(3, 17) festgestellt werden. Systematischev ergleichende funktionell-mor-phometrische Untersuchungen derV enae gastrocnemiae beie inemv enengesunden und venenkranken Kollektivb ezüglich der Anzahl der vorhandenenGastrocnemiusvenen, desVenenquerschnitts und derAnalyse derh ämodynamischen Situation liegen nicht vor.…”

Section: Résuméunclassified

Gastrocnemius- und Poplitealvenendurchmesser bei Patienten mit chronischen Venenkrankheiten

Pannier¹,

Lotz²,

Rabe³

2007

Phlebologie

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ZusammenfassungChronische Venenkrankheiten haben in der erwachsenen Durchschnittsbevölkerung eine große Bedeutung. In der Bonner Venenstudie hatten 23% eine Varikose und 15% eine chronische venöse Insuffizienz (CVI) (28). Über die Bedeutung der Gastrocnemiusvenen bei chronischen Venenkrankheiten ist nur wenig bekannt. Patienten, Methoden: In der vorliegenden Untersuchung wurde an insgesamt 135 Patienten ein Venenstatus erhoben und an streng definierten Stellen der unteren Extremität der Durchmesser der medialen Gastrocnemius- und der Poplitealvenen ermittelt. Davon waren: 76 Venengesunde, 34 Patienten mit einer Stammvarikose der Vena saphena magna, 16 Patienten mit einer Stammvarikose der Vena saphena parva, 9 Patienten mit sonstigen Venenerkrankungen: dreimal postthrombotisches Syndrom (PTS), zweimal PTS und Stammvarikose der Vena saphena magna, viermal inkomplette Stammvarikose. In der Gruppe der an der Vena saphena parva Erkrankten (n = 16) konnte in 10 Fällen eine gleichzeitige Insuffizienz einer großen Stammvene diagnostiziert werden. Gemäß den klinischen Stadien nach der CEAP-Klassifikation (5) verteilten sich die Patienten folgendermaßen: C0 und C1: 79 Patienten (C0: 74, C1: 5), C2 und C3: 30 Patienten (C2: 16, C3: 14), C4: 16 Patienten (C4a: 15, C4b: 1), C5 und C6: 10 Patienten (C5: 3, C6: 7). Ergebnisse: Die Durchmesser der Venae gastrocnemiae sowie der Venae popliteae weisen bei Venenkranken durchschnittlich einen höheren Querschnitt auf, als bei Venengesunden. In 9 von 12 untersuchten Parametern der Venae gastrocnemiae konnte ein statistisch signifikanter Unterschied zwischen venengesunden und venenkranken Probanden festgestellt werden. Die Durchmesserunterschiede betrugen teilweise über 2 mm (Vv. gastrocnemiae) im Mittelwert zwischen Stadium C0+1 CEAP und Stadium C5+6 nach CEAP. Schlussfolgerung: Bei der chronischen venösen Insuffizienz kommt es im Rahmen der Varikose neben der Erweiterung der Vena poplitea auch zu einer Dilatation der Muskelvenen im medialen Anteil des Musculus gastrocnemius.

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Variable Venous Anatomy of the Popliteal Fossa Demonstrated by Duplex Scanning

Abstract: When SPJ incompetence is suspected, duplex scanning identifies the exact location of the junction and other associated pathology in the popliteal fossa, and allows the position of the junction to be marked on the leg preoperatively.

Cited by 21 publications

References 13 publications

A prospective evaluation of the outcome after small saphenous varicose vein surgery with one-year follow-up

A prospective evaluation of the outcome after small saphenous varicose vein surgery with one-year follow-up

Lower limbs venous kinetics and consequent impact on drainage direction

Gastrocnemius- und Poplitealvenendurchmesser bei Patienten mit chronischen Venenkrankheiten

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