Superficial epigastric vein sparing in the saphenous-femoral crossectomy or in the closures of the saphena magna
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Abstract
AIM: Considerations based on years of experience, have led our school to spare the superior collateral vein: the superficial epigastric vein.
MATERIAL OF STUDY: 1536 selective epigastric-sparing crossectomies performed with the support of Duplex US to detect the normal functioning of terminal saphenous-fermoral junction and femoral valves.
RESULTS: The selective-haemodynamic sapheno-femoral junction ligation” (although this is not strictly done), saves from ligation (but only in the presence of functioning femoral and saphenous terminal valves) and division the termination of the superficial epigastric vein into the common femoral vein.
DISCUSSION: Superficial epigastric vein is a descending draining vessel, assisted by gravity (unlike the inferior collaterals). In case of obesity or portal hypertension, the spared superficial epigastric vein could drain into the common femoral vein keeping its anatomical and haemodynamic functions.
CONCLUSIONS: The resulting anterograde flow will provide some flow through the residual saphenous stump, preventing its thrombosis.