Giacomini projection of the lesser saphenous vein and associated operative strategy in lesser saphenous vein stripping

Abstract

Objectives: ‘Giacomini vein’ is the term used to describe the thigh extension branch of the lesser saphenous vein. It courses the posterior thigh as a trunk projection of the lesser saphenous vein. Although its existence has minor importance in majority of patients with varicose disease, missing its existence during the surgical treatment of varicosities of lesser saphenous vein may cause catastrophic results. In this article we aimed to present prevalence of Giacomini vein, and the strategies to prevent related undue complications. Materials and Methods: Between January 2011 and May 2013, Two hundred and fifteen patient records were reviewed retrospectively in order to investigate Giacomini vein prevalence in young adult patients who underwent venous surgery due to varicose veins. Data regarding the mean age of the patients, existence of varicose dilatation of Giacomini vein and association with lesser saphenous vein tortuosity, and common variations of Giacomini vein were analysed. Results: The age of patients were 21.54 ± 0.81 (min: 21, max: 25). A hundred and sixty-nine patients underwent great saphenous vein stripping plus venous pack extirpation, and twenty-eight patients underwent lesser saphenous vein stripping plus venous pack extirpation and eighteen patients underwent only venous pack extirpation. Conclusions: It should be kept in mind that saphenopopliteal junction level demontsrate variations. Missing this information may result in catastrophic complication such as popliteal vein tearing during lesser saphenous vein stripping in the presence of low-level saphenopopliteal junction.