Adnan ÖZDEMİR, Yunus YILMAZSOY, Serdar ARSLAN

Safenofemoral bileşke düzeyi major süperfisiyal ven varyasyonları; ultrasonografi yöntemi ile değerlendirilmesi

Amaç: Bu çalışmanın amacı varis tedavisinde oldukça önemli bir bölge olan safenofemoral bileşke düzeyinin yüzeyel venöz vasküler anatomik varyasyonlarının ultrasonografi ile ortaya konulmasıdır.Gereç ve Yöntem: Hastanemiz radyoloji bölümüne Şubat 2017 – Temmuz 2018 tarihleri arasında venöz yetmezlik ön tanısıyla yönlendirilen 79 hasta çalışmaya dâhil edildi ve toplam 158 safenofemoral bölge venöz vasküler anatomisi B-mod ve renkli doppler ultrasonografi ile değerlendirdi. Safenofemoral bölge yüzeyel venöz vasküler anatomisi detaylı olarak incelendi, Glasser ve Daseler anatomik sınıflandırmalarına göre sınıflandırıldı ve varyasyon sıklıkları hesaplandı.Bulgular: Çalışmamızda Glasser sınıflandırmasına göre en sık görülen grup 30 (%19) safenofemoral bölgede izlenen tip 2C olurken, bunu tip 2B ve 2C takip etti. Daseler sınıflandırmasına göre en sık izlenen safenofemoral bölge varyasyonu tip H (VIII) olurken bunu tip F (VI) ve tip E (V) takip etti. Safenofemoral bileşke düzeyinde safena magnaya açılan süperfisiyal venöz dal sayıları değerlendirildiğinde, 1 ile 5 arasında süperfisiyal venöz dalın açıldığı izlendi. Bunlardan en sık 78 (%49) olguda izlenen üç venöz dalın açıldığı tespit edildi. Bunu sırasıyla iki venöz dalın açıldığı 50 (%32) olgu, dört venöz dalın açıldığı 25 (%16) olgu, bir venöz dalın açıldığı 3 (%2) olgu ve beş venöz dalın açıldığı 1 (%1) olgu takip etti.Sonuç: Safenofemoral bileşke düzeyinde major süperfisiyal venöz yapıların ayrıntılı anatomisinin ultrasonografi ile ortaya konulması, variköz venlerin etiyopatogenezinin ayrıntılı bir şekilde ortaya konmasına yardımcı olmasının yanı sıra selektif tedavi planlanmasına ve dolayısıyla tedavi sonuçlarına katkı sağlayacağı kanaatindeyiz.

Anahtar Kelimeler:

Safenofemoral bileşke, yüzeyel venöz varyasyonlar, ultrasonografi, doppler, anatomik sınıflandırma

Saphenofemoral region major superficial vein variations; evaluated by ultrasonography technique

Aim: The purpose of this study is to present superficial venous vascular anatomic variations of the saphenofemoral junction, which is a very important region in variceal treatment, by ultrasonography technique.Material and Method: Seventy nine patients who were referred to our radiology department and pre-diagnosed for venous insufficiency between February 2017 and July 2018 were included in the study and a total number of 158 venous vascular anatomy of saphenofemoral regions were evaluated by B- mode and color doppler ultrasonography. The superficial venous vascular anatomy of the saphenofemoral regions were evaluated in detail, classified according to the anatomical classifications of Glasser and Daseler, and the frequencies of variations were calculated.Results: In our study, the most common group according to the Glasser classification was type 2C observed in 30 (19%) saphenofemoral regions followed by type 2B and 2C. Type H (VIII) was the most common type of saphenofemoral region according to the Daseler classification followed by Type F (VI) and type E (V). Between 1 to 5 superficial venous branches draining to saphena magna were observed at the level of saphenofemoral junction. Three venous branches draining to the saphena magna were observed in 78 (49%) saphenofemoral junctions followed by two venous branches in 50 (32%) saphenofemoral junctions, four venous branches in 25 (16%) saphenofemoral junctions, one venous branch in 3 (2%) saphenofemoral junctions and five venous branches in 1 (1%) saphenofemoral junction, respectively.Conclusion: We think the assessment of the detailed anatomy of the major superficial venous structures at the level of the saphenofemoral junction by doppler ultrasonography will help to elucidate the etiopathogenesis of the varicose veins as well as contribute to the selective treatment planning and consequently the treatment results.

Keywords:

Saphenofemoral junction, superficial venous variations, ultrasonography, doppler, anatomic classification,

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