The sites of proximal reflux associated with the saphenopopliteal junction also constitute a frequent source of postoperative recurrence. These sites can be suprafascial: Giacomini veins derived from the long saphenous vein. perineal veins, and branches of the lateral and anterior aspects of the thigh. The therapeutic management of these recurrences is easier when they have been previously identified by ultrasound mapping. Associated proximal reflux can also be derived from perforating veins with a longitudinal, subfascial, and intramuscular course, related to…
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Anevrysmal dilatation can occur in the short saphenous vein at the saphenopopliteal junction (Figure 103).This dilatation can make a ligation flush with the popliteal vein particularly difficult. In this case, recurrence is related to an anatomical factor accentuating the hemodynamic factor. Varicose veins will then develop not on a perforating vein of the popliteal fossa independent of the short saphenous vein, but on the stump of the ectatic saphenopopliteal junction. For example, figure 104 illustrates an early recurrence, occurring 5…
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The particular anatomical and hemodynamic characteristics of the veins of the popliteal fossa are responsible for a number of therapeutic difficulties. Firstly, the anatomical difficulties of this region are related to the confluence of popliteal and saphenous collecting vessels and muscle draining veins. The hemodynamic difficulties are due to the fact that the popliteal fossa is the site of very intense pressure variations. The intramuscular network constitutes a very large blood reservoir which is suddenly, mobilized during muscle contraction. The…
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