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KMID : 0980120190170010023
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Annals of Phlebology
2019 Volume.17 No. 1 p.23 ~ p.26
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Sonographic Evaluation of the Relationship between the Small Saphenous Vein and an Adjacent Nerve in the Saphenous Fascial Compartment
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Hong Ki-Pyo
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Abstract
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Backgrounds: This is a cross-sectional observational study involving 231 patients (390 limbs) aims to determine the sonographic correlation between the small saphenous vein and nerve in the saphenous fascial compartment.
Methods: A sonographic evaluation was performed at 5 levels between popliteal crease and lateral malleolus. Of these stages, the assessment primarily focuses on 3 of the following: the existence of nerve in the saphenous fascial compartment, a distance between the small saphenous vein and nerve within the saphenous fascial compartment, and lastly, the risk pont, where a distance between the small saphenous vein and nerve is under 5 mm.
Results: A total of 370 limbs (221 patients) were enrolled for the study. 20 limbs were excluded because nerve images were not definite. Distribution of risk points were as follows; 1) S1: 3 limbs (0.8%), 2) S2: 24 limbs (6.5%), 3) S3: 78 limbs (21.1%), 4) S4: 168 limbs (45.4%), 5) S5: 363 limbs (98.1%).
Conclusions: Sonographic evaluation has shown that a guideline of access based upon classic clinical anatomy is unreliable for the endovenous thermal ablation of small saphenous vein. Preoperative meticulous ultrasound-guided mapping is necessary both to prevent nerve injury and ablate a maximum length of the incompetent segment.
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KEYWORD
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Small saphenous vein, Sural nerve, Ultrasound
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