Sapheno-femoral junction is incompetent with reversal of flow on Valsalva maneuver. Great saphenous vein is dilated throughout its course. Multiple dilated subcutaneous veins are seen along medial aspect of lower thigh and leg suggestive of varicose veins.

What is SFJ incompetence?

Background: It is usually agreed that incompetence of the sapheno-femoral junction (SFJ) is the main indication for stripping or ablation of the great saphenous vein (GSV) in the treatment of varicose veins (VVs). We wanted to test this assumption in our surgical treatment of varicose veins.

How do you test for Saphenofemoral incompetence?

The combined Doppler and tourniquet test appears to be the most simple, rapid and accurate means of detecting saphenofemoral incompetence.

What is the saphenofemoral junction?

From Wikipedia, the free encyclopedia. The sapheno-femoral junction (SFJ) is located at the saphenous opening within the groin and formed by the meeting of the great saphenous vein (GSV), common femoral vein and the superficial inguinal veins (confluens venosus subinguinalis).

What is long saphenous vein incompetence?

Long saphenous vein insufficiency is the most common form of venous insufficiency in people presenting with symptoms. People with venous insufficiency may have symptoms of fatigue, heaviness, aching, throbbing, itching and cramps in the legs.

Great saphenous vein - Animated Gross anatomy of lower limb ( Courtery : Dr vishram singh )

Which saphenous vein is used in CABG?

The most commonly used graft was the saphenous vein (particularly the great saphenous vein) and is still in use. However, due to the success story of the left internal mammary artery LIMA, total arterial revascularization has gained much importance for coronary bypass graft surgery.

What is vein mapping for varicose veins?

Vein mapping refers to an ultrasound test that can be done to take a closer look at the veins in the legs. This test is non-invasive and painless. The study may also be referred to as a venous insufficiency (or venous reflux) ultrasound.

What is an incompetent perforator vein?

Radiofrequency perforator ablation (RFPA)

The radiofrequency current heats the inside of the perforator causing it to shrink down and remove the abnormal flow between the deep and varicose veins. The whole process takes approximately 10 minutes per perforating vein.

Is the saphenofemoral junction a deep vein?

The saphenofemoral junction is a proximal connection between the superficial and deep veins in the lower limb. Great saphenous vein (GSV) is one of the main superficial veins which runs from the ankle to the groin at the medical aspect of the leg. Normally the GSV drains medially into the common femoral vein (CFV).

What is femoral vein?

The femoral vein is the main deep vein of the thigh and accompanies the superficial femoral artery and common femoral artery.

How do you assess Saphenofemoral Junction?

1. Place one finger, with a small amount of pressure, onto the saphenofemoral junction (SFJ) which is located 4cm inferior-lateral to the pubic tubercle.
2. Tap the varicose vein you are assessing, which should be located lower down the leg.

How is venous insufficiency measured?

Changes in limb volume are measured by air displacement in a cuff surrounding the calf during maneuvers to empty and fill the venous system (Figure 4). Venous outflow is assessed during rapid cuff deflation on an elevated limb that has a proximal venous occlusion cuff applied.

How do you scan venous insufficiency?

During the Ultrasound

You may be asked to change positions in order to obtain images of each vein. The technician will press the transducer on your legs and will squeeze your legs. This may cause a slight discomfort for some patients. A venous insufficiency ultrasound usually takes 60-75 minutes to complete.

How do Trendelenburg test for varicose veins?

To perform this test, elevate the patient's leg until all of the congested superficial veins collapse. Apply direct pressure to occlude the superficial veins below the point of suspected reflux from the deep system into the superficial varicosity.

What happens when the valves in the veins are incompetent?

Chronic venous insufficiency occurs when your leg veins don't allow blood to flow back up to your heart. Normally, the valves in your veins make sure that blood flows toward your heart. But when these valves don't work well, blood can also flow backwards. This can cause blood to collect (pool) in your legs.

What causes venous insufficiency?

• High blood pressure in the leg veins over time, due to sitting or standing for long periods.
• Lack of exercise.
• Smoking.
• A blood clot in a deep vein, often in the calf or thigh (deep vein thrombosis)

What is the femoral triangle?

The femoral triangle is a hollow region located in the supero-medial part of the anterior thigh. It appears most prominently with hip flexion, abduction and internal rotation. It is an easily accessible area through which multiple neurovascular structures pass through.

What is occlusive thrombus?

A thrombus that completely obstructs the flow of blood through a vessel is known as an occlusive thrombus, and can result in the death of tissue supplied by the obstructed vessel. Tissue death in this context is known as an infarct.

What are perforator veins?

What Are Perforating Veins? The connections between the deep and superficial venous systems are called perforating veins and can have faulty valves as well. When blood begins to flow backwards or the valve is otherwise functioning improperly, pressures can build within the vein walls.

How do you treat an incompetent perforator?

Minimally invasive treatments have replaced traditional surgical treatments for incompetent perforator veins. Current minimally invasive treatment options include ultrasound guided sclerotherapy (USGS) and endovascular thermal ablation (EVTA) with either laser or radiofrequency energy sources.

Can venous insufficiency affect the heart?

So, to sum up, venous insufficiency doesn't affect the heart or cause heart problems to progress. On the other hand, existing heart problems, especially congestive heart failure, can make vein problems in the legs much worse depending on the degree of the heart issue.

What is Lipodermatosclerosis?

Lipodermatosclerosis refers to changes in the skin of the lower legs. It is a form of panniculitis (inflammation of the layer of fat under the skin). Signs and symptoms include pain, hardening of skin, change in skin color (redness), swelling, and a tapering of the legs above the ankles.

What is arterial mapping?

Ultrasound is a procedure that uses sound waves to "see" inside your body. An arterial duplex ultrasound uses sound waves to create a color map of the arteries in your legs to identify: Narrowing of your vessels that may be causing leg pain when walking.

What is venous mapping?

What is a vein mapping examination? A vein mapping examination uses ultrasound to see how large the veins are. An ultrasound is a non-invasive test using sound waves, gel and a small probe to produce an image of the veins in the legs and/or arms. An ultrasound uses no radiation, dyes, or needles.

What is leg mapping?

Vein mapping is a technique performed with an ultrasound probe that uses sound waves (doppler) technology to view or “map” all of the veins under the skin on the arms or legs. It allows the doctor to see the size, depth, and flow of blood in these veins and allows for better treatment planning.