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Nouveautés dans l’anatomie saphénienne: anatomie planaire des veines saphènes et leurs rapports avec les fascias.
No full textThe "interfascial" veins of the lower limbs
No full textThe veins of the lower limb are commonly divided in deep and superficial ones according to their position with respect to the Muscular Fascia (MF). Anatomical textbooks affirm that all superficial veins are thin walled vessels that run in a yielding layer of fat. Accordingly, no differences between saphenous Veins (SVs) and their tributaries (TVs) are reported by physiologists and pathophysiologists. On the contrary, the SVs do not correspond to the classic anatomic, physiologic and clinical descriptions of the "superficial" veins. In fact, the SVs: 1) are not superficial because they course between the SF and the MF; 2) they are not thin vessels, being their wall thick and rich in muscular cells; 3) they actively contribute to the complex mechanisms of venous return from the lower limbs; and finally, 4) they are quite resistant to hypertension and usually afflicted with limited varicose changes. As a consequence, the SVs should not be longer considered "real" superficial veins and the venous bed of the lower limb would be better represented by a three-layered model
Ultrasonography of skin changes in legs with chronic venous disease
No full textBackground: In daily practice, ultrasonography (US) is used only to designate the location and pattern of venous
lesions. Skin US is not performed between routine venous investigations.
Methods: Skin morphology is evaluated by the same probes used for routine Duplex evaluation of superficial
veins. US findings from evident skin lesions are comparatively evaluated with those from the surrounding
apparently normal skin and from the contralateral leg.
Results: Inflammation and dermal edema can be found in the apparently normal skin of C2 legs. Swollen legs
show thickening of the subcutaneous layer as a result of diffuse soaking or anechoic cavities, with or without
dermal edema. Chronic hypodermitis is characterized by inflammatory edema in initial phases, and by
liposclerosis in advanced cases. Recrudescence of inflammation provokes focal rarefactions of the subcutaneous
layer, possibly related to ulcer opening.
Conclusion: In legs with venous disorders, sonography refines clinical evaluation of the skin and may reveal
changes not highlighted by inspection. Some of these changes could require further investigation because they
have not yet been explained or described. Skin sonography should improve knowledge of the natural history of
skin changes, as well as contribute to a better grading of venous diseases severity In particular, US evidence of
cutaneous and subcutaneous changes in C2 legs should be considered to stratify the treatment in C2 legs, by
identifying those in which varicose veins are not simply a cosmetic problem
Primary varicose veins of the upper limbs
No full textPrimary varicose veins (VVs) of the upper limb are
very rare with only few reports in the last decades. In
this article, a case of symptomatic primitive VV of the
left upper limb is reported including diagnosis and
treatment
Regarding "Venous valves and major superficial tributary veins near the saphenofemoral junction"
No full textVengono corrette erronee descrizioni della posizione delle valvole safeno-femoral
Die chirurgische anatomie des venensystems der unteren extremität
No full textViene descritta l'anatomia clinica e chirurgica del letto venoso degli arti inferior
Clinical anatomy of the venous system of the lower limb.
No full textvIENE DESCRITTA LA ANATOMIA CLINICA E CHIRURGICA DELLE VENE DEGLI ARTI INFERIOR
The saphenous venous compartments
No full textThe relationships between the connective framework of the lower extremity hypodermis and the saphenous veins was studied by dissection, stereomicroscopy, ultrasonography and histology in 64 lower limbs. A fibroelastic lamina was evidenced in the hypodermis of the medial aspect of the thigh and leg and in the back face of the leg. This lamina, together with the underlying muscular fascia, fixed the boundaries of two compartments occupied by the saphenous veins and nerves. The adventitia of the saphenous veins was connected to the compartment walls by thick connective strands. The saphenous veins ran deeply in the hypodermis, closely ensheathed by a fibroelastic sleeve. As a consequence, they could no longer be considered as a truly superficial vein. This term seems to be appropriate only for their tributaries, which ran in a more superficial plane just below the dermis. The role of the saphenous vessels in blood return from the lower limbs may be greater than classically accepted. In fact, due to their close fascial ensheathing and adventitial anchoring, muscular contractions may enhance blood flow within these vessels as occurs in the intermuscular veins. Finally, dilative pathology of the saphenous vein may be resisted by the membranous lamina as a sort of a fibroelastic shield
Venous valves: gateway to the circulation
No full textThis manuscript summarizes the history of the discovery of venous valves (VV) and of their function. Then, the main theories on VV role in venous diseases are reported. Finally, the recent introduction of surgery of VV is reported
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