title: Anatomic variations of lower extremity venous system in varicose vein patients: demonstration by three-dimensional CT venography.
abstract: Background Understanding the anatomy of the lower extremity veins is essential for successful varicose vein treatment. Computed tomography (CT) venography may be used to obtain a comprehensive overview and detailed information regarding this. Purpose To describe anatomic variations of the lower extremity venous system in patients with varicose veins, using three-dimensional (3D) CT venography. Material and Methods A total of 810 limbs in 405 patients with suspected varicose veins were prospectively referred to undertake CT venography and included in our study population retrospectively. The CT venography images were evaluated by consensus of two cardiovascular radiologists. Anatomical variations of the lower extremity venous system and their incidence were analyzed. Specifically, the number of tributaries at saphenofemoral junction, relative location of the great saphenous vein (GSV) with respect to the common femoral artery bifurcation, pattern of saphenopopliteal junction, and end of thigh extension from the small saphenous vein (SSV) were assessed. Results The most frequent number of tributaries joining the GSV was four (44.4%, 360/810). Only 0.7% (6/810) of the limbs demonstrated unusual location of the GSV between the bifurcated superficial and deep femoral arteries. The most common pattern of veins at the saphenopopliteal junction was a larger caliber of saphenopopliteal junction than thigh extension from SSV (43.8%, 355/810), end of which joining the femoral vein directly (41.0%, 288/703). Conclusion CT venography with 3D reconstruction can be used to understand the anatomy of lower extremity veins and how their variations contribute to varicose veins.
authors: 1 Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.|2 Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.|3 Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.
authors: Rihyeon
authors: R
authors: Kim
authors: 1 Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.|2 Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.|3 Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.
authors: Whal
authors: W
authors: Lee
authors: 1 Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.|2 Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.|3 Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.
authors: Eun-Ah
authors: EA
authors: Park
authors: 1 Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.|3 Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.
authors: Jin Young
authors: JY
authors: Yoo
authors: 1 Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.|2 Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.|3 Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.
authors: Jin Wook
authors: JW
authors: Chung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D063405:Anatomic Variation; D003287:Contrast Media; D005260:Female; D005268:Femoral Vein / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007472:Iohexol / Q000031:analogs & derivatives; D035002:Lower Extremity / Q000033:anatomy & histology / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D010690:Phlebography / Q000379:methods; D011152:Popliteal Vein / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D011856:Radiographic Image Enhancement / Q000379:methods; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D014648:Varicose Veins / Q000000981:diagnostic imaging*; D055815:Young Adult
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide
keywords: Varicose veins; anatomy; computed tomography (CT); lower extremity; veins