Kim Duk Sil, Kim Sung Wan, Lee Hyun Seok, Byun Kyung Hwan, Choe Michael SungPil
Department of Thoracic and Cardiovascular Surgery, CHA Gumi Medical Center, CHA University.
Department of Radiology, CHA Gumi Medical Center, CHA University.
Korean J Thorac Cardiovasc Surg. 2017 Apr;50(2):99-104. doi: 10.5090/kjtcs.2017.50.2.99. Epub 2017 Apr 5.
We observed several cases of rare vascular anomalies within the femoral triangle during varicose vein operations.
From among 2,093 patients who underwent stripping operations of the great saphenous vein between January 2002 and June 2016, 14 cases of rare vascular anomalies were enrolled in this study.
Twelve cases of femoral artery and vein transposition (0.57%), 1 case of separate entrance of the great saphenous vein trunk and its tributaries (0.05%), and 1 case of separate entrance with femoral artery and vein transposition (0.05%) were observed. The preoperative diagnosis rate was 71% (10 of 14) using duplex ultrasound. In all cases of femoral artery and vein transposition, the saphenofemoral junction was located at the lateral or posterolateral side of the superficial femoral artery, corresponding to complete or incomplete transposition, respectively. Among the 12 cases of femoral artery and vein transposition, 5 cases were complete transposition and 7 cases were incomplete transposition. In 2 cases of separate entrance of the great saphenous vein trunk and its tributaries, the separated tributaries formed a common trunk before connecting to the femoral vein.
The anatomy of the saphenofemoral junction may infrequently be altered in some individuals. Detailed preoperative sonographic examinations and meticulous groin dissection during the operation are necessary to prepare for unexpected anatomical variations.
我们在静脉曲张手术过程中观察到几例股三角内罕见的血管异常情况。
在2002年1月至2016年6月期间接受大隐静脉剥脱手术的2093例患者中,本研究纳入了14例罕见血管异常病例。
观察到12例股动静脉转位(0.57%)、1例大隐静脉主干及其属支单独汇入(0.05%)以及1例大隐静脉主干及其属支单独汇入合并股动静脉转位(0.05%)。使用双功超声的术前诊断率为71%(14例中的10例)。在所有股动静脉转位病例中,隐股静脉汇合处位于股浅动脉的外侧或后外侧,分别对应完全或不完全转位。在12例股动静脉转位病例中,5例为完全转位,7例为不完全转位。在2例大隐静脉主干及其属支单独汇入病例中,分离的属支在连接股静脉之前形成一个共同主干。
隐股静脉汇合处的解剖结构在某些个体中可能偶尔会发生改变。术前进行详细的超声检查以及术中对腹股沟进行细致的解剖对于应对意外的解剖变异是必要的。