Варианты топографии сосудов зоны trigonum femorale Scarpae

Abstract

Access to the femur triangle is often used in vascular surgery: virtually all operations on the venous system require access to the saphenofemoral junction, and if the arterial system is affected, access to the femoral artery is necessary for a significant number of surgical interventions. Classical descriptions of topographic anatomy and operative surgery characterize the area of the Scarp triangle, or the femoral triangle, as a region with a permanent topography of the vessels: under the superficial leaf of the broad fascia, within the femoral triangle, there are large femoral vessels surrounded by the vagina – a. and v. femoralis. Topographically, the artery is lateral, the vein is medial. They lie in the recess, which forms the muscles of the bottom of the femoral triangle – m. iliopsoas (outside) and m. pectineus (inside), covered with a deep leaf of the broad fascia. The main branches of these vessels at the subfascial level are a. and v. profunda femoris, leaving at a distance of 3-5 and 6-8 cm below the inguinal ligament from the main trunks. At the episfascial level, v. femoralis has another major influx – v. saphena magna, which passes in the fatty deposits of the medial surface of the thigh. In the femoral triangle, the vein penetrates the wide fascia of the thigh through hiatus saphenus, flows into the femoral vein from the medial surface, forming a saphenofemoral anastomosis. Inflows v. saphena magna on the thigh – v. epigastrica superficialis, vv. pudendae externae and v. circumflexa ilium superficialis – flow into it within the femoral triangle. In addition, there may be less permanent tributaries: v. saphena accessoria medialis and v. saphena accessoria lateralis. At the same time, in practice, there are variants of individual variability in the topography of the vessels in this area, which can create difficulties and lead to errors both in the course of diagnosis and in the following – when performing surgical interventions. In the article, the main variants of the topography of the femoral triangle vessels, revealed by ultrasonic duplex scanning of vessels, are presented in clinical examples. Keywords: Trigonum femorale Scarpae, variants of vessel topography..