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Ultrasound Evaluation and Mapping of the Superficial Venous System
Ann Marie Kupinski
OBJECTIVES
List the indications for venous mapping
Describe the normal anatomical features of the great saphenous vein, small saphenous vein, cephalic vein, and basilic vein
Identify the pathology observed within the superficial veins
Describe the basic techniques of venous mapping
List the equipment necessary for vein mapping
Define limitations encountered during vein mapping
Describe diagnostic ultrasound criteria used in venous mapping
KEY TERMS
basilic vein | calcification | cephalic vein | great saphenous vein | mapping | perforator | planar arrangement | recanalization | small saphenous vein | varicosities
GLOSSARY
great saphenous vein a superficial vein forming at the level of the medial malleolus, which courses medially along the calf and thigh and terminates into the common femoral vein at the saphenofemoral junction
perforating vein a vein that connects from the superficial venous system to the deep venous system
Ultrasound has been used to evaluate the venous system for more than 25 years. The use of venous ultrasound has increased greatly and its applications have also expanded. The early application of ultra- sound in the venous system had centered mainly on the detection of a thrombus within the deep venous system.1 Soon after clinicians realized the usefulness of deep venous ultrasound, they began to extend ul- trasound to evaluate the superficial venous systems.2 The superficial venous systems were of interest both to assess their competency as well as their suitability as a bypass conduit.2,3 Superficial veins are used for a variety of types of bypass procedures, not the least of
recanalization a vein that was previously thrombosed
small saphenous vein a superficial vein that course along the posterior aspect of the calf, usually terminating at the popliteal fossa into the popliteal vein
varicosities dilated tortuous superficial veins
which is coronary artery bypass grafting. The autoge- nous vein is the preferred conduit of choice for lower extremity arterial bypass procedures. Lastly, growing interest in creating hemodialysis access fistulas in lieu of dialysis grafts presents yet another reason why the status of the superficial veins must be assessed.
When planning to use a segment of superficial vein for a procedure, surgeons gather as much information as possible to aid in the successful performance of these surgeries. Vein patency, position, depth, and size are some of the characteristics assessed preoperatively. These details provided by ultrasound imaging allow for the selection of the optimal vein. Proper knowledge
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