Location and hemodynamic role of perforating veins independent of saphenous veins

Abstract Background The perforating veins of the lower limbs (LL) have valves that enable the blood flow to be directed from the superficial vein system to the deep vein system and they may or may not be connected to the saphenous vein system. Objectives To use vascular ultrasonography (VUS) to identify the frequency, location, caliber, and hemodynamic role of perforating veins that do not connect to saphenous veins, during preoperative mapping of LL varicose veins. Methods A cross-sectional study was conducted using VUS in women to study the frequency, location, distance from the sole of the foot, and hemodynamic role of perforating veins. Results The frequencies of perforating veins independent of the saphenous veins were 92.6%, 5.1%, and 2.3%, in the leg, thigh, and knee, respectively, and 25.2% of them were incompetent while 72.3% were drainage veins. The mean diameters of perforating veins were 2.9 mm, 3.5 mm, and 3.7 mm, in the leg, thigh, and knee, respectively. Perforating veins were located at mean distances of 23.8 cm, 43.6 cm, and 59.4 cm above the sole of the foot in the leg, knee, and thigh, respectively. Perforating veins with reflux had a mean caliber of 3.5 mm, irrespective of location. Conclusions Perforating veins independent of the saphenous veins are most frequent in the leg, draining reflux from tributary veins. Irrespective of location, perforating veins with reflux had mean caliber of 3.5 mm.摘要 背景：下肢穿通静脉（perforating veins）配有瓣膜，可引导血液从浅静脉系统流向深静脉系统，此类静脉可与隐静脉系统（saphenous vein system）相连，亦可无关联。 目的：本研究旨在通过血管超声检查（vascular ultrasonography，VUS），明确下肢静脉曲张术前定位测绘中，与隐静脉系统无关联的穿通静脉的检出率、分布位置、管径大小及血流动力学作用。 方法：本研究采用横断面研究设计，纳入女性受试者，通过血管超声检查分析穿通静脉的检出率、分布位置、距足底的距离及血流动力学作用。 结果：在小腿、大腿及膝关节部位，与隐静脉系统无关联的穿通静脉检出率分别为92.6%、5.1%及2.3%；其中25.2%的此类静脉存在瓣膜功能不全，72.3%为引流静脉。小腿、大腿及膝关节部位的穿通静脉平均管径分别为2.9mm、3.5mm及3.7mm。小腿、膝关节及大腿部位的穿通静脉距足底的平均距离分别为23.8cm、43.6cm及59.4cm。存在反流的穿通静脉平均管径为3.5mm，与其分布位置无关。 结论：与隐静脉系统无关联的穿通静脉在小腿部位最为常见，其功能为引流属支静脉的反流血液。无论分布位置如何，存在反流的穿通静脉平均管径均为3.5mm。