18Feb 2018

ANATOMICAL MEASUREMENTS OF GREAT SAPHENOUS VEIN AND SUPERFICIAL FEMORAL VEIN BY COLORED DUPLEX ULTRASOUND.

  • Anatomy & Embryology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
  • Vascular surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt. Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
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Vascular ultrasonography has an important role in the diagnosis and management of venous disease. The venous system, however, is more complex and variable compared to the arterial system due to its frequent anatomical variations. Thus, the aim of our study was to assess the great saphenous vein and superficial femoral vein at different levels and its relation to age, sex and body mass index in Egyptian population by noninvasive colored duplex ultrasound. Methods: Our study was cross- sectional descriptive study comprised 75 subjects with one hundred fifty- limbs. We classified studied subjects to lean and obese group according to body mass index (BMI). The diameter of the greater saphenous vein and femoral vein in mm were measured with duplex ultrasound longitudinal imaging in three different levels.at both lower limbs and in standing as well as supine position. Results: Obese patients had significantly higher diameter (mm) of the femoral vein compared to lean controls. However, the diameter (mm) of great saphenous vein of the both lower limb in the different levels (1 st Standing,2nd Standing 3 rd Standing 1 st Supine 2 nd Supine and 3 rd Supine) were non-significantly higher in obese women compared to lean subjects. Moreover, there were significantly higher diameter (mm) of great saphenous vein at 1 st Standing,2nd Standing 3 rd Standing in both lower limbs compared to corresponding levels in Supine position. By using ROC curve test, we found that the highest area under the curve (AUC) (0.797, C.I 0.669 - 0.924), sensitivity (96.1%) and specificity (63%) were of femoral vein diameter (mm) with cutoff (7.15 mm). linear regression analysis test found that, the diameter of femoral vein (mm) was only independently correlated with BMI. Conclusion: obese subjects had significantly higher diameter (mm) of the femoral vein compared to lean control. However, the diameter (mm) of great saphenous vein of the both lower limb in the different levels were non-significantly higher in obese women compared to lean subjects.


  1. Shah DM, Chang BB, Leopold PW, Corson JD, Leather RP, Karmody AM. The anatomy of the greater saphenous venous system. J Vasc Surg. 1986; 3:273-83.
  2. Zygmunt J., Jr What is new in duplex scanning of the venous system. Perspect Vasc Surg Endovasc Ther. 2009; 21:94?104. [PubMed]
  3. N?llen H, Noppeney T. Diagnosis and treatment of varicose veins: part 2: therapeutic procedures and results. Chirurg. 2010;81(12):1125?1138. German. [PubMed]
  4. Hoballah JJ, Corry DC, Rossley N, Chalmers RT, Sharp WJ. Duplex saphenous vein mapping: venous occlusion and dependent position facilitate imaging. Vasc Endovascular Surg. 2002;36(5):377?380. [PubMed]
  5. Davies AH, Magee TR, Jones DR, Hayward JK, Baird RN, Horrocks M. The value of duplex scanning with venous occlusion in the preoperative prediction of femoro-distal vein bypass graft diameter. Eur J Vasc Surg. 1991;5(6):633?636. [PubMed]
  6. Wong JK, Duncan JL, Nichols DM. Whole-leg duplex mapping for varicose veins: observations on patterns of reflux in recurrent and primary legs, with clinical correlation. Eur J Vasc Endovasc Surg. 2003;25(3):267?275. [PubMed]
  7. Cina A, Pedicelli A, Di Stasi C, et al. Color-Doppler sonography in chronic venous insufficiency: what the radiologist should know. Curr Probl Diagn Radiol. 2005;34(2):51?56.
  8. Szendro G, Nicolaides AN, Zukowski AJ, et al. Duplex scanning in the assessment of deep venous incompetence. J Vasc Surg. 1986; 4:237-42.
  9. Sarin S, Scur JH, Smith PD. Medial calf perforators in venous disease: the significance of outward flow. J Vasc Surg. 1992; 16:40-6.
  10. Labropoulos N, Leon M, Nicolaides AN, Giannoukas AD, Volteas N, Chan P. Superficial venous insufficiency: correlation of anatomic extent of reflux with clinical symptoms and signs. J Vasc Surg. 1994; 20:953-8
  11. Myers KA, Ziegenbein RW, Hua Zeng G, Matheus PG. Duplex scanning for chronic venous disease: patterns of venous reflux. J Vasc Surg. 1995; 21:605-
  12. . Luccas GC, Nagase Y, Menezes FH, et al. Cirurgia de varizes dos membros inferiores: avalia??o pr?-operat?ria do Sistema venoso com mapeamento duplex. Cir Vasc Angiol. 1996;12:15-20.
  13. Ruoff BA, Cranley JJ, Hannan LA, et al. Real-time duplex ultrasound mapping of the great saphenous vein before in situ infrainguinal revascularization. J Vasc Surg. 1987;6:107-13.
  14. Kugler C, Strunk M, Rudofsky G. Venous pressure dynamics of the healthy human leg. Role of muscle activity, joint mobility and anthropometric factors. J Vasc Res 2001; 38: 20?29
  15. Am?lia Seidel, Fausto Miranda Jr., Yara Juliano, Neil F. Novo Relationship between the diameter of great saphenous vein and body mass indexJ Vasc Br 2005;4(3):265-9.
  16. Arfvidsson B, Eklof B, Balfour J. Iliofemoral venous pressure correlates with intraabdominal pressure in morbidly obese patients. Vasc Endovascular Surg 2005; 39: 505?509.
  17. Willenberg T, Schumacher A, Amann-Vesti B, Jacomella V, Thalhammer C, Diehm N et al. Impact of obesity on venous hemodynamics of the lower limbs. J Vasc Surg 2010; 52: 664?668. |
  18. Willenberg T, Clemens R, Haegeli LM, Amann-Vesti B, Baumgartner I, Husmann M. The influence of abdominal pressure on lower extremity venous pressure and hemodynamics: A human in-vivo model simulating the effect of abdominal obesity. Eur J Vasc Endovasc Surg 2011; 41: 849?855.
  19. Coon WW, Willis PW, Keller JB. Venous thromboembolism and other venous disease in the Tecumseh community health study. Circulation 1973; 48: 839?46.
  20. Widmer LK. Peripheral venous disorders, Basel III. Bern: Hans Huber,1978.
  21. Callam MJ. Epidemiology of varicose veins. Br J Surg 1994; 81: 167?73.
  22. K Kr?ger, C Ose, G Rudofsky, J Roesener, D Weil and and H Hirche Peripheral veins: influence of gender, body mass index, age and varicose veins on cross-sectional area Vasc Med 2003 8: 249 .
  23. Monahan KD, Dinenno FA, Seals DR, Halliwill JR. Smaller age-associated reductions in leg venous compliance in endurance exercise-trained men. Am J Physiol Heart Circ Physiol 2001; 281: 1267?73.
  24. Smit AAJ, Halliwil JR, Low PA, Wieling W. Pathophysiological basis of orthostatic hypotension in autonomic failure. J Physiol 1999; 519:1-10.
  25. Burke D, Sundlo?f G, Wallin BG. Postural effects on muscle nerve sympathetic activity in man. J physiol 1977; 272: 399?414.

[Ibrahim A. Maher, Hosam A. Tawfik, Ibrahim.H. El-Azzony, Nearmeen M. Rashad and Rania H.M. Soliman. (2018); ANATOMICAL MEASUREMENTS OF GREAT SAPHENOUS VEIN AND SUPERFICIAL FEMORAL VEIN BY COLORED DUPLEX ULTRASOUND. Int. J. of Adv. Res. 6 (Feb). 1012-1020] (ISSN 2320-5407). www.journalijar.com


Nearmeen M. Rashad
Ass. professor of medicine

DOI:


Article DOI: 10.21474/IJAR01/6522      
DOI URL: http://dx.doi.org/10.21474/IJAR01/6522