Anatomico-ultrasound basis of optimization of the great subcutaneous vein surgery in varicose disease of lower extremities


150 patients with varicose disease of lower extremities in the great subcutaneous vein system (GSV) were examined with the help of ultrasound duplex scanning. Location and quantity of valves and varicose nodes in GSV were detected, the diameter of supplementary anterolateral  and posteromedial inflows was measured and the location of their confluence into GSV was detected. Comparison of data about venous valves location in GSV, about varicose nodes location obtained during the ultrasound examination with the results of  macro-microscopic investigation of distant GSV was carried out. The obtained data give evidence about the necessity of preoperative ultrasound mapping of varicose nodes and the investigated inflows location and about their obligatory ligation for prevention of subcutaneous haematomas formation on the thigh after saphenectomy. By the confluence of the anterolateral  and posteromedial inflows into GSV more than 7 centimetres away from an inguinal fold it is reasonably to do an additional mini-cut in the place of the mapped confluence, that will allow to ligate an inflow safely and adequately.

Оренбургская государственная медицинская академия

Author for correspondence.

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