Tabira Yoko, Iwanaga Joe, Tanaka Shinichi, Kikuchi Keishiro, Shimizu Keigo, Harano Tatsuya, Han Aya, Haikata Yuto, Inoue Eiko, Saga Tsuyoshi, Tubbs R Shane, Watanabe Koichi
Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Fukuoka, Japan.
Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.
Thromb J. 2024 Nov 18;22(1):102. doi: 10.1186/s12959-024-00672-x.
The high incidence of deep vein thrombosis (DVT) in evacuees has been recognized since the 2004 Niigata-Chuetsu Earthquake in Japan. We hypothesized that the number and location of communicating branches of the soleal veins might influence thrombus development and that the median septum of the soleus muscle influences the venous network of the soleal veins. This study aimed to investigate how the network of soleal veins varies with the shape and thickness of the median septum and to elucidate factors predisposing soleal veins to DVT. The lower legs of 30 sides from 15 formalin-preserved cadavers were observed. The central soleal vein, the predilection site for thrombus among the six veins within the soleus muscle, divides into three branches: medial, central, and lateral. The soleus muscle has a unique architecture with converging muscle fibers on the anterior surface of the median septum. We examined the positional relationship between the central soleal vein and the median septum. The median septum morphology was either straight (14 sides, 46.7%) or curved (16 sides, 53.3%). The number of communicating branches was significantly higher in the curved type. The curved type also had a communicating vein penetrating the median septum, with the central branch passing deeper than in the straight type. The median septum could restrict the enlargement of communicating branches, causing thrombosis through disturbance of venous blood flow. Future research will clarify the median septum's influence on the soleal vein, potentially identifying soleus muscles at high risk of developing DVT.
自2004年日本新潟中越地震以来，撤离人员中深静脉血栓形成（DVT）的高发病率已得到公认。我们推测，比目鱼肌静脉交通支的数量和位置可能会影响血栓形成，并且比目鱼肌的正中隔会影响比目鱼肌静脉的静脉网络。本研究旨在探讨比目鱼肌静脉网络如何随正中隔的形状和厚度变化，并阐明比目鱼肌静脉发生DVT的易感因素。观察了15具福尔马林固定尸体的30侧小腿。比目鱼肌内六条静脉中血栓形成的好发部位——比目鱼肌中央静脉分为三支：内侧支、中央支和外侧支。比目鱼肌具有独特的结构，肌纤维在正中隔前表面汇聚。我们研究了比目鱼肌中央静脉与正中隔之间的位置关系。正中隔形态为直线型的有14侧（46.7%），曲线型的有16侧（53.3%）。曲线型的交通支数量明显更多。曲线型还有一条穿通正中隔的交通静脉，其中央支走行比直线型更深。正中隔可能会限制交通支的扩张，通过干扰静脉血流导致血栓形成。未来的研究将阐明正中隔对比目鱼肌静脉的影响，可能会识别出发生DVT风险较高的比目鱼肌。
