Clinical and anatomical variants of varicose veins in the basin of small subcutaneous vein

Abstract

The aim — to distinguish variants of the topography of the small subcutaneous vein (SSV) and its femoral branch (FB) according to the ultrasound scan, as well as to determine the pathways for the spread of venous reflux and to develop anatomical and hemodynamic classification of varicose veins (VV) types. Materials and methods. We analyzed the results of the study of SSV topography variants in 474 patients of the general population and ways of distribution of blood reflux in SSV basin in 126 patients with VV, who were diagnosed and treated at O. O. Shalimov National Institute of Surgery and Transplantology of NAMS of Ukraine within the period of 2003 — 2007. Results and discussion. 6 variants of topography of SSV and 5 variants of topography of its FB were singled out. The most common variant, which occurs in 47.0 % of patients, is the influx of SSV into the popliteal vein with an isolated trunk. In the total number of the examined patients, SSVs had hip extension in the form of FB in 40.9 % and had no fistula with popliteal vein in 17.9 % of cases. The study of ways of venous reflux spreading made it possible to distinguish the following types of FB in the SSV basin: 1) the trunk type — in 76.2 %; 2) the inflow type — in 17.5 %; 3) the perforation type — in 6.3 % of patients. Conclusions. The most common type that occurs in 76.2 % of patients is the formation of blood reflux at the level of sapheno­popliteal fistula and its spread along the SSV trunk. Of the total number of patients with VV, an «atypical» distribution of blood reflux was registered in 23.8 % of cases.