Varicose veins in the anterior accessory great saphenous vein system of the lower limb
DOI:
https://doi.org/10.14739/mmt.2025.2.324994Keywords:
varicose veins, varicose veins in the anterior accessory great saphenous vein system, great saphenous vein, blood reflux, crossectomyAbstract
Aim. In order to improve the results of the treatment of patients with varicose veins and to prevent the recurrence of the disease, a quantitative analysis of the types of varicose veins in the anterior accessory great saphenous vein (GSV) system should be carried out according to the source of their reflux.
Materials and methods. In the vascular department of the Transcarpathian regional hospital named after A. Novak in Uzhhorod, we treated 3000 patients with varicose veins of the subcutaneous veins of the lower extremities in 2018–2025. Varicose veins in the anterior accessory great saphenous vein system were noted in 111 (3.7 %) patients. Inclusion criterion for the study: diagnosis of varicose veins of the lower extremities with varicose veins in the anterior accessory GSV system was established using ultrasound examination of the superficial and deep veins of the iliofemoral segment. Exclusion criterion: the presence of concomitant serious diseases. In type I, the varicosed anterior accessory great saphenous vein flows into the GSV in its upper third, and in type II, the varicosed trunk is not connected with the GSV.
Results. Among patients with type I varicose veins in the system of the anterior accessory great saphenous vein 49 (55.1 %) patients, variant 3 was observed, which corresponded to classical varicose disease with a single dilation of the GSV and its tributaries. The second place was taken by 31 (34.8 %) patients with maximum dilation of the GSV, where the varicose GSV passes into the lateral vein, and distal to the GSV was not dilated. In type II varicose veins in the anterior accessory great saphenous vein system in 13.6 % of cases the source of reflux was incompetent perforating veins from the deep femoral vein, in 27.3 % – incompetent perforating veins connected to the common femoral vein. In more than 59.1 % of patients with type II varicose veins in the anterior accessory great saphenous vein system the source of reflux was the iliofemoral basin connected through the perforating veins of the inferior gluteal vein.
Conclusions. The optimal approach to the classification of varicose veins within the anterior accessory great saphenous vein system is based on the source of reflux. In the case of type I varicose veins in the anterior accessory great saphenous vein system, classical phlebectomy of the GSV is effective in any way. However, in the case of type II varicose veins in the anterior accessory great saphenous vein system, it is necessary to eliminate the perforating veins, which are the source of reflux from the iliofemoral segment.
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