The surgical anatomy of the small saphenous vein and adjacent nerves in relation to endovenous thermal ablation

Kerver, Anton; Ham, Arie C. van der; Theeuwes, Hilco P.; Eilers, Paul H.C.; Poublon, Alex; Kerver, Albertus J.H.; Kleinrensink, Gert-Jan

doi:10.1016/j.jvs.2011.11.127

Cited by 56 publications

(44 citation statements)

References 17 publications

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“…After stimulation, each rat received an overdose of pentobarbital and the hind paw was removed for subsequent analysis. The 360° view of extravasation areas was recorded and quantified using an Optical Projection Tomography scanner, computer assisted surgical anatomy mapping technology, 16 and Adobe Photoshop. Moreover, the intraanimal differences in extravasation areas are shown in different shades of blue representing the incidence (i.e., 1-6) of extravasation resulting from the stimulation of the saphenous nerve.…”

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confidence: 99%

Long-term follow-up of peptidergic and nonpeptidergic reinnervation of the epidermis following sciatic nerve reconstruction in rats

Kambiz

Duraku

Baas

et al. 2015

JNS

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OBJECT Peripheral nerve injuries are a commonly encountered clinical problem and often result in long-term functional deficits. The current gold standard for transected nerves is an end-to-end reconstruction, which results in the intermittent appearance of neuropathic pain. METHODS To improve our understanding of the relation between this type of reconstruction and neuropathic pain, the authors transected and immediately end-to-end reconstructed the sciatic nerve in rats. The effect of this procedure on neuropathic pain, as measured by thermal and mechanical hypersensitivity at 4 different time points (5, 10, 20, and 30 weeks), was related to the density of peptidergic and nonpeptidergic fiber innervation in the glabrous skin of rats' hind paws. RESULTS Thermal hypersensitivity occurring 20 weeks after reconstruction was accompanied by a significant increase in peptidergic epidermal fibers. However, the lesion-induced reduction in the density of nonpeptidergic epidermal fibers remained decreased at all experimental time points. Moreover, temporal collateral sprouting by undamaged saphenous nerve was visualized using the recently revised Evans blue extravasation technique. Strikingly, as the sciatic nerve repopulated rats' hind paw, the saphenous nerve withdrew to its original territory. CONCLUSIONS The authors conclude that the transient thermal hypersensitivity is related to increased density of epidermal peptidergic fibers, which mainly originate from regenerating fibers. Furthermore, a changed composition in the peptidergic and nonpeptidergic epidermal fibers is demonstrated following end-to-end reconstruction of the sciatic nerve.

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confidence: 99%

Long-term follow-up of peptidergic and nonpeptidergic reinnervation of the epidermis following sciatic nerve reconstruction in rats

Kambiz

Duraku

Baas

et al. 2015

JNS

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“…The combination of surgery and sclerotherapy was adopted in our cases to obtain the more stable results, to minimize the surgical approach in order to avoid complications by traumatic or thermal damage to the superficial nerve and artery [6][7][8] and finally to perform fast and inexpensive procedures [18]. The bandaging with refrigerant padding and the choice of the elastic stocking class of compression by venous pressure measurement criteria [17,18] appeared to be helpful in the postoperative period and were not followed by patient's complaints.…”

Section: Discussionmentioning

confidence: 99%

“…The outflow into the deep system and the anatomical variants were investigated on the bases of literature's information: variations of the SPJ location, SSV outflowing into other superficial or deep veins, other anatomical variations such as aneurysm or multiple outlets, different sources of reflux such as the medial gastrocnemious, the popliteal non-saphenous, the gluteal and lateral thigh perforators, the intersaphenous communicating vein, the medial accessory vein of the great saphenous (Giacomini) and the varicose veins of the sciatic nerve were investigated [7][8][9][10][11][12][13][14][15][16].…”

Section: Methodsmentioning

confidence: 99%

“…In the cases where the previous intervention was performed at the PR, a careful direct surgical dissection was carried on from the superficial layers, through and below the fascia, and the residual veins were made free from the fibrotic surrounding tissue, deeper and close to the outflow into the popliteal vein or into other veins in the cases with anatomical variations of the confluence. When a long SS was found in the politeal fossa, the surgical dissection was performed taking care of the gastrocnemial veins, of the superficial sural nerve and artery [7][8][9]. In 13 limbs (68.4%), the surgical interruption was combined with intraoperative foam sclerotherapy [18] with polidocanol, 3 -5 mL at 1.5% of concentration by DUS-guided injection into the distal stump of the SSV or into other incompetent recurrent varices.…”

Section: Methodsmentioning

confidence: 99%

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Causes and Treatment of Varicose Recurrence in the Popliteal Region

Corcos¹,

Pontello²,

Ferlaino³

et al. 2017

J Curr Surg

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Background: In a previous study of 1,081 limbs affected with varicose recurrence (VR) at the saphenofemoral junction (SFJ) and at the sapheno-popliteal junction (SPJ), the anatomical causes were investigated. VR appeared to be due to inadequate diagnosis and surgery; neoangiogenesis appeared to play a minimal role. The so-called cavernoma was secondary to reflux and consisted with a complex collateral circulation (CC). Only 52 of 1,081 (4.8%) studied limbs developed a VR at the SPJ, but the anatomical findings were poorly described. The aims of this study were: 1) to distinguish between VR at the SPJ and the ones caused by different sources of reflux, 2) the reliability of the preoperative DUS examination, and 3) the efficacy and safety of the treatment.

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“…Its anatomy is of clinical importance since the SN is frequently used for biopsy and nerve graft to diagnose neuropathies and repair nerve injuries, respectively (Matsuyama et al, 2000;Mikell et al, 2013). In addition, the SN can be injured during surgery of varicosed small saphenous vein (SSV) (Mondelli et al, 1997;Kerver et al, 2012) and repair of calcaneal tendon rupture (Molloy & Wood, 2009).…”

Section: Introductionmentioning

confidence: 99%

Anatomy of the Sural Nerve Related to Calcaneal Tendon, Intermalleolar Line and Small Saphenous Vein

et al. 2016

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DANGINTAWAT, P.; HUANMANOP, T.; AGTHONG, S. & CHENTANEZ, V.Anatomy of the sural nerve related to calcaneal tendon, intermalleolar line and small saphenous vein. Int. J. Morphol., 34(1):380-384, 2016. SUMMARY:Sural nerve (SN) courses from the posterior aspect of leg to the lateral side of ankle and foot. Anatomy of the SN is of clinical importance due to its involvement in nerve biopsy, nerve graft harvesting including injuries during calcaneal tendon repair. Despite substantial knowledge in the literature, more easily located landmarks and data regarding the symmetry are still needed. Ninetyeight lower extremities from 31 males and 18 females were dissected in this study. The SN originated from the union between the medial and lateral sural cutaneous nerves in 52.0 % of the legs. The distance from the union point to the intermalleolar line (IML) was 16.3±8.4 (SD) cm. The ratio of this distance to the fibular length (apex of head to lateral malleolus or LM) was 0.47±0.23 cm. In 84.7 % of the legs, the SN initially coursed medial to and then crossed the lateral border of calcaneal tendon at the distance of 8.4±2.1 cm above the IML. The ratio to the fibular length was 0.25±0.06 cm. At the level of IML, the SN was posterior to the most prominent part of the LM in 95.9 % of the legs with the distance of 2.6±0.5 cm. At the closest point, the SN was lateral to the small saphenous vein in 74.5 % of the legs and the distance from this point to the IML was 10.6±4.7 cm. The ratio to the fibular length was 0.31±0.14 cm. Side difference or asymmetry was observed in a substantial number of specimens. These data are crucial for not only localizing the SN during biopsy and graft harvesting but also avoiding the nerve injury during relevant surgical procedures.

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The surgical anatomy of the small saphenous vein and adjacent nerves in relation to endovenous thermal ablation

Cited by 56 publications

References 17 publications

Long-term follow-up of peptidergic and nonpeptidergic reinnervation of the epidermis following sciatic nerve reconstruction in rats

Long-term follow-up of peptidergic and nonpeptidergic reinnervation of the epidermis following sciatic nerve reconstruction in rats

Causes and Treatment of Varicose Recurrence in the Popliteal Region

Anatomy of the Sural Nerve Related to Calcaneal Tendon, Intermalleolar Line and Small Saphenous Vein

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