Course Of Vein Research Articles

Acute spontaneous vortex vein occlusion: clinical features, multimodal imaging and natural course

AimsTo describe the clinical features, multimodal imaging, treatments and natural course of acute spontaneous vortex vein occlusion.MethodsClinical data were collected on nine patients with acute vortex vein occlusion. The symptoms...

An unilateral double fenestration of the right external jugular vein: a rare variant.

This report presents a rare anatomical variation, double fenestration of the External jugular vein on the right side. During the routine dissection of a male cadaver aged 60 years, we observed a unilateral large double fenestration of the External jugular vein on the right side. After its formation from the posterior division of the retromandibular and posterior auricular veins, External jugular vein descended in the posterior triangle of neck. Here, it divided into medial, intermediate, and lateral veins that united again before draining into the subclavian vein. Lateral vein was the largest (7.2cm) and intermediate and medial veins were measuring 6.4cm each. Two large fenestrations, measuring 5.8cm each, arranged like a "double bubble" were seen in the External jugular vein extending from fourth to sixth cervical (C4 to C6) vertebrae. The medial branch of supraclavicular nerve was seen passing superficial to the distal part of External jugular vein. On the left side, the course of External jugular vein showed a standard pattern. Surgeons must be acquainted with the varied anatomy of the superficial neck veins to prevent major bleeding during operative procedures, including carotid endarterectomy, flap operations, & central venous catheterisation.

Course and Relation of the Facial Vessels-An Anatomical Study.

Background and Objectives: Facial vascular anatomy plays a pivotal role in both physiological context and in surgical intervention. While data exist on the individual course of the facial artery and vein, to date, the spatial relationship of the vasculature has been ill studied. The aim of this study was to assess the course of facial arteries, veins and branches one relative to another. Materials and Methods: In a total of 90 halved viscerocrania, the facial vessels were injected with colored latex. Dissection was carried out, the relation of the facial vessels was studied, and the distance at the lower margin of the mandible was measured. Furthermore, branches including the labial and angular vessels were assessed. Results: At the base of the mandible, the facial artery was located anterior to the facial vein in all cases at a mean distance of 6.2 mm (range 0-15 mm), with three cases of both vessels adjacent. An angular vein was present in all cases, while an angular artery was only present in 34.4% of cases. Conclusions: The main trunk of the facial artery and vein yields a rather independent course, with the facial artery always located anterior to the vein, while their branches, especially the labial vessels, demonstrate a closer relationship.

Vascular microforamina and endocranial surface: Normal variation and distribution in adult humans.

The term craniovascular traits refers to the imprints left by arteries and veins on the skull bones. These features can be used in biological anthropology and archaeology to investigate the morphology of the vascular network in extinct species and past populations. Generally, the term refers to macrovascular features of the endocranial cavity, like those associated with the middle meningeal artery, venous sinuses, emissary foramina, and diploic channels. However, small vascular passages (here called microforamina or microchannels) have been occasionally described on the endocranial surface. The larger ones (generally with a diameter between 0.5 and 2.0 mm) can be detected through medical scanners on osteological collections. In this study, we describe and quantify the number and distribution of these microforamina in adult humans (N = 45) and, preliminarily, in a small sample of children (N = 7). Adults display more microchannels than juvenile skulls. A higher frequency in females is also observed, although this result is not statistically significant and might be associated with allometric cranial variations. The distribution of the microforamina is particularly concentrated on the top of the vault, in particular along the sagittal, metopic, and coronal sutures, matching the course of major venous sinuses and parasagittal bridging veins. Nonetheless, the density is lower in the region posterior to bregma. Beyond oxygenation, these vessels are likely involved in endocranial thermal regulation, infection, inflammation, and immune responses, and their distribution and prevalence can hence be of interest in human biology, evolutionary anthropology, and medicine.

Anatomical variant of the azygos vein course in a cancer patient and review of the literature

The azygos vein is responsible for drainage through a staff of venous blood from the chest wall for the most part. Sometimes its course causes the independence of part of the lung parenchyma, which is known as the accessory lobe of the azygos. The present article presents the casual radiological finding of this anatomical variant in a 70-year-old patient undergoing a computed tomography scan for colon cancer. The azygos accessory lobe is a mostly asymptomatic anatomical variation, but it can be a problem in some thoracic surgeries.

Cochlear aqueduct revisited: A histological study using human fetuses

Background and aimThe cochlear aqueduct (CA) connects between the perilymphatic space of the cochlea and the subarachnoid space in the posterior cranial fossa. The study aimed to examine 1) whether cavitation of the CA occurs on the subarachnoid side or the cochlear side and 2) the growth and/or degeneration of the CA and its concomitant vein. MethodsWe examined paraffin-embedded histological sections from human fetuses: 15 midterm fetuses (crown-rump length or CRL, 39–115 mm) and 12 near-term fetuses (CRL, 225–328 mm). ResultsA linear mesenchymal condensation, i.e., a likely candidate of the CA anlage, was observed without the accompanying vein at 9–10 weeks. The vein appeared until 15 weeks, but it was sometimes distant from the CA. At 10–12 weeks, the subarachnoid space (or the epidural space) near the glossopharyngeal nerve rapidly protruded into the CA anlage and reached the scala tympani, in which cavitation was gradually on-going but without epithelial lining. However, CA cavitation did not to occur in the anlage. At the opening to the scala, the epithelial-like lining of the CA lost its meningeal structure. At near-term, the CA was often narrowed and obliterated. ConclusionThe CA develops from meningeal tissues when the cavitation of the scala begins. The latter cavitation seemed to reduce tissue stiffness leading, to meningeal protrusion. The so-called anlage of CA might be a phylogenetic remnant of the glossopharyngeal nerve branch. A course of cochlear veins appears to be determined by a rule different from the CA development.

Prevalence of Azygos Lobe of the Lung in Southern Indian Cadaveric Population: A Retrospective Observational Study

Introduction: The azygos lobe is a developmental anomaly found in the upper lobe of the right lung. It has a prevalence of 0.4% in clinical scenarios and 1% during routine anatomical dissections. Clinically, the azygos lobe mimics various conditions. It is a rare incidental finding during chest radiography or Computed Tomography (CT). Aim: To determine the prevalence of the azygos lobe during anatomical dissection. Materials and Methods: A retrospective observational study was conducted over a 13-year period from June 2010 to August 2023 in various medical colleges in Mangaluru, Karnataka, India. A total of 102 adult cadavers were studied. The dissected right and left lungs of each cadaver were examined for the presence or absence of an azygos lobe and recorded. The morphology of the azygos lobe was studied, including its size, the presence of the azygos fissure, the depth of the azygos fissure, and the course of the azygos vein. The presence of mesoazygos was also checked, and its attachments were noted. Descriptive statistics were used in terms of frequency and percentage. Results: Out of the 102 cadavers, only one right lung had an azygos lobe. None of the cadavers had bilateral azygos lobes. The maximum height of the lobe was 5.8 cm, and the width was 4.5 cm. An azygos fissure was found, through which the mesoazygos was present. The mesoazygos was located from the lung to the thoracic wall. Conclusion: Despite being an incidental finding, the azygos lobe is clinically important. Physicians should be aware of this anomaly, and thoracic surgeons should exercise caution during surgeries involving the thoracic region, such as Video-Assisted Thoracic Sympathectomy (VATS).

A Cadaveric Study On Clinical Correlations of the Internal Jugular Vein and its Variations

Introduction: The largest paired vein is the internal jugular vein (IJV), which rests laterally adjacent to the main the common carotid artery (CCA) within the carotid triangle at the extremities of the neck. It is the main source of blood flow down from the sigmoid sinus of dural venous sinuses. The obstruction of blood flow or distension of the internal jugular vein can lead to increasing intracranial pressure in the brain and face. The increased the right atrial pressure can be a sign of heart failure, cardiovascular problems, and pulmonary embolism. The aims are to study and note down variations in the course and relations of the internal jugular vein and variations of tributaries of right IJV and left IJV diameter and effects on cardiovascular diseases. Materials and Methods: An observational based cadaveric study was conducted on twenty-four unclaimed embalmed cadavers were dissected from March 2021 to August 2023 in Bidar Institute of Medical Sciences, Bidar, Karnataka, India. Dissection procedure was followed by Cunningham’s manual of practical anatomy volume-3 book. Variations and pattern of bilateral internal jugular veins were observed. Results: External jugular vein access is a highly advantageous location for a heart catheterization. The tributaries of the internal jugular vein form the trunk and overlap on the common carotid artery bifurcation, which leads to adverse effects on baroreceptors and chemoreceptors at the level of divisions of internal and external carotid arteries. The pattern of the right and left internal jugular is quite significant. Conclusion: The study will generate information that would be useful for surgeons, and other clinical physicians and give necessary morphometric data on the internal jugular vein in the South Indian population.

Experience in the lower extremities trophic ulcers treatment in patient with combined pathologies: varicose veins and rheumatoid arthritis

Varicose veins of the lower extremities is one of the most common diseases on Earth and its combination with other diseases is inevitable. The combination of diseases aggravates the course of each other. Rheumatoid arthritis worsens the course of varicose veins with trophic disorders – both independently – an increase in pro-inflammatory factors, a change in microcirculation, deformation of the limb axis with a violation of musculoskeletal function, and treatment of rheumatoid arthritis reduces the immune response of the body reducing the reparative capabilities of the body. Clinical case: a patient with a long course of rheumatoid arthritis and varicose veins. For a long time he used cytostatic drugs with a subsequent transition to hormonal drugs. For about 5 years, he noted the appearance of ulcers on both shins, which took a circular shape, which significantly reduced the quality of life and did not respond to conservative treatment. He repeatedly underwent inpatient treatment with intravenous administration of general restorative and vascular drugs. He was also constantly observed in the polyclinic at the place of residence with the implementation of local treatment of ulcerative surfaces. The patient was successively treated for varicose veins by endovenous laser coagulation of the trunks of large subcutaneous veins. The second stage was performed debridement of the wound surface and skin grafting with a free perforated flap. Between the stages, the appointment of drug therapy according to clinical recommendations. Rheumatoid arthritis and varicose veins aggravate each other, especially trophic manifestations. Treatment of such patients should be carried out by a team ofspecialists of various profiles together. Step-by-step treatment ofsuch patients with careful preparation for each of them shows excellent results. A special place is occupied by the patients’ commitment to treatment.

Rare variations of cephalic vein drainage: two case reports.

Throughout the years, anatomic studies have demonstrated numerous variations in the course of the cephalic vein (CV). There are, however, very rare cases of uncommon formation, course, or termination of the vein to which our attention should be drawn. During routine dissections conducted in the Department of Anatomy and Neurobiology, in 2 formalin-fixed cadavers, very rare anatomical variants were found. In an 80-year-old Caucasian female the right cephalic vein, after crossing the clavipectoral triangle, ascended anterior and superior to the clavicle and drained into the lateral branch of the right external jugular vein, which in turn opened to the right subclavian vein. In the second case, the dissection of an 83-year-old Caucasian male cadaver revealed that, after passing through the deltopectoral groove, the left cephalic vein ran between clavicle and subclavius muscle to terminate in the left subclavian vein. Understanding of the topography, morphology, and anatomical variations of the cephalic vein is important not only for anatomists but for clinicians and nurses. Such knowledge can prevent multiple complications during many invasive procedures including implantation of cardiac implantable electronic devices, central venous access, arteriovenous fistula creation, or iatrogenic injuries during clavicle or glenohumeral joint surgery.

OA15 Missing the wood(-y induration) for the trees

OA15 Missing the wood(-y induration) for the trees

Variations of azygos vein: a cadaveric study with clinical relevance.

The azygos vein can be formed as a single root, two roots, and three roots, namely lateral, intermediate and the medial roots respectively. The hemiazygos vein and the accessory hemiazygos vein are the tributaries of azygos vein rather than its left side equivalents. Its variations, especially in young persons without any relevant risk factors, may result in thromboembolic illness. This study aimed to describe the morphological and morphometric variations of azygos system of veins. The present study was conducted on thirty formalin fixed adult human cadavers by dissecting azygos vein from formation to termination and variations were noted. The azygos vein was formed by a single root in 56.7%, by two roots: the lateral root and intermediate root in 36.7% cases and by the lateral root and medial root in 6.6%. The vertebral level of termination of azygos vein was seen at the level of T4 vertebrae in 70% cases, at the level of T3 vertebrae in 20% of cases and at the level of T5 vertebrae in 10% cases. The course of azygos vein was varying in 13.3%. These morphological variations can be useful while performing mediastinal surgery, mediastinoscopy, surgery of the deformations of the vertebral column, neurovascular surgeries of the retroperitoneal organs, disc herniation and fracture of thoracic vertebrae.

Analysis of hemodynamic changes in vertebral arteries and veins during functional tests with ultrasound monitoring

Aim to evaluate the correlation between the course of vertebral arteries and veins and the results of calculations of hemodynamic parameters during ultrasound with functional tests.
 Material and methods. In the observation, 252 volunteers were examined using Samsung SonoAce R7 and GE Logiq F6 equipment. The hemodynamics was studied at the level of the second segment of the vertebral arteries and veins at rest, when turning, tilting and lifting the head. The results were processed using Microsoft Excel 2007 with subsequent statistical analysis.
 Results. 504 vascular complexes were analyzed without taking into account the visualization side. When assessing the arteries, the highest maximum blood flow velocity was registered when lifting the head in women with a rectilinear course of the vessels. In the group of men with non-rectilinear course of vessels, the lowest average blood flow velocity was registered when tilting the head. The highest volume flow was recorded in case of non-rectilinear vascular course in women when lifting the head.
 For vertebral veins, the highest indicators of maximum and minimum venous blood flow rates were observed in men with a rectilinear course of vessels when lifting the head. The highest values of the average flow velocity and volume flow were noted in men who had a rectilinear course of the vessels.
 The maximum values of the calculated venous volume flow were registered in groups with rectilinear vascular course: in men up to 19.4214.85 ml/min. (Me 12.45 ml/min.), in women 18.52 15.30 ml/min. (Me 10.50 ml/min.).
 Conclusion. The data obtained by the study contributes to improving the software and analysis of individual changes during patient examination, helps to evaluate the effectiveness of treatment and rehabilitation, as well as to analyze multifactorial models.

Drainage Pattern of Craniofacial Veins With Emphasis on its Influence on Facial Reconstruction Procedures.

As the facial transplantation procedures are becoming more popular and frequent in recent years, for repairing facial trauma, variations in the veins of head and neck needs to be reported time and again. This study was undertaken to examine the course and drainage pattern of the facial vein and external jugular vein on this context and emphasize its surgical implications. The authors studied the head and neck region of 50 embalmed cadavers of both sexes to document normal and variant anatomy of facial, retromandibular, and external jugular veins. In 30% of the head and neck regions, different draining pattern of the above-mentioned veins were observed. One of the rare variation discovered was the splitting of the retromandibular vein to embrace the external carotid artery within the parotid gland. The data about variations in the termination of facial vein, retromandibular vein, and external jugular vein, as observed in the present study might be useful in avoiding accidental injury to these vessels during any surgical intervention in the face as well as neck. Level of Evidence: IV.

The effect of the A82G mutation in the MMP-12 gene and C634G mutation in the VEGF-A gene on the course of lower limb varicose veins and the risk of disease recurrence

Aim: creation of a method for predicting the development of varicose veins of the lower extremities and its recurrence.Object and methods. 2 independent studies of patients with C2-C6 varicose veins of the lower extremities (CEAP-classifier) were conducted. In the first, with ultrasound diagnosis of the main veins of the lower extremities and genomic analysis of blood samples, 75 participants (men 20, women 55), mean age 43.7 ± 5.9 years. All patients were randomized into two groups: group I (n = 17) – with recurrent varicose veins; Group II (n = 58) – applied with varicose veins for the first time. The 2nd study involved 44 (men 10, women 34), mean age 55.5 ± 2.7 years. Similarly, patients were divided into groups – I (5) and II (39 people). All patients of the first stage of the study underwent real-time PCR with allele-specific primers to determine the A82G mutation in the MMP-12 gene (matrix metalloproteinase-12) and the second stage C634G in the VEGF-A gene (endothelial fibroblast growth factor – A).Results of the study. In patients of both groups I and II, having the MMP-12 gene in the heterozygous variant, dilatation of the tibial and popliteal veins was present (6.4 ± 0.3 mm and 10.7 ± 0.24 mm, respectively) with the presence reflux and slowing down the evacuation of blood from the deep venous system. In patients of group I, the MMP-12 gene was found in 80 % of cases, as A/A (homozygous) and A/G (heterozygous variation), while in group II only in 33.3 % of cases. Pearson's goodness-of-fit criterion χ2 = 10.4 (the critical value of the criterion is 6.63), p < 0.01. The frequency of recurrence of varicose veins and mutation of the MMP-12 gene according to the Spearman test was 1.0 with the number of degrees of freedom 23, p < 0.05. In the 2nd study, a correlation was found between groups I and II of patients with the C/C genotype (Pearson's coefficient χ2 = 0.79, p < 0.11) and a correlation in the duration of the disease between groups of patients with the C/C genotype (homozygous variation) and C /G (heterozygous variation) – Pearson correlation coefficient χ2 = 0.92 (p < 0.01).Conclusion. The revealed relationship between the MMP-12 gene polymorphism and the frequency of varicose vein recurrence is a predictor of the development of structural changes in the vein wall, and a mutation in the VEGF-A gene occurs with a long history of the disease.

Surgical treatment of anomalous right upper lobe pulmonary vein obstruction caused by compression between pulmonary artery and trachea: a case report.

The normal anatomical course of right upper lobe pulmonary vein involves drainage anteriorly to the pulmonary artery, ultimately reaching the left atrium. However, anomalies can occur with the most common variation involving the convergence of the right upper lobe pulmonary vein with the superior vena cava. In a rare pulmonary vascular malformation, the anomalous right upper lobe pulmonary vein takes a path between the right pulmonary artery and right main bronchus [1]. During a clinical consultation, a patient presented in our hospital with this specific anomalous right upper lobe pulmonary vein, along with an atrial septal defect and a patent ductus arteriosus. As a consequence of this aberrant positioning, the right upper lobe pulmonary vein was compressed between the pulmonary artery and trachea, leading to pulmonary vein obstruction. Thus, a successful pulmonary vein replantation was performed to correct the congenital malformation.

The Course and Variation of the Facial Vein in the Face-Known and Unknown Facts: An Anatomical Study.

Background and Objectives: The facial vein is the main collector of venous blood from the face. It plays an important role in physiological as well as pathological context. However, to date, only limited data on the course and tributaries of the facial vein are present in contemporary literature. The aim of this study was to provide detail on the course and the tributaries of the facial vein. Materials and Methods: In 96 sides of 53 body donors, latex was injected into the facial vein. Dissection was carried out and the facial vein and its tributaries (angular vein, ophthalmic vein, nasal veins, labial veins, palpebral veins, buccal and masseteric veins) were assessed. Results: The facial vein presented a textbook-like course in all cases and crossed the margin of the mandible anterior to the masseter in 6.8% of cases, while being located deep to the zygomaticus major muscle in all cases and deep to the zygomaticus minor in 94.6% of cases. Conclusions: This work offers detailed information on the course of the facial vein in relation to neighboring structures, which shows a relatively consistent pattern, as well as on its tributaries, which show a high variability.

Changes of biliary cilia, smooth muscle tissue distribution, innervation and extracellular matrices during morphological evolution of hepatic architectures in vertebrates

BackgroundThe liver architecture of vertebrates can be classified into two types, the portal triad type (having periportal bile ducts) and the non-portal triad type (having bile ducts independent of the course of portal veins). The former is typically detectable in livers of tetrapods and cartilaginous fish, and its ancestral state is found in the hagfish, an earliest diverged lineage among vertebrates. Teleosts other than osteoglossomorphs have the latter. The aim of the present study is to reveal the changes of the hepatic innervation, biliary cilia and smooth muscle distribution, and extracellular matrices along vertebrate evolution with attention to the two types of liver architectures. MethodsThe hepatic innervation, biliary cilia and smooth muscle distribution, and collagen deposition were immunohistochemically and histochemically compared among livers of various vertebrates, using anti-acetylated tubulin and anti-α-smooth muscle actin antibodies, and Sirius red staining. These were also ultrastructurally examined. ResultsAlthough the hagfish liver had periportal intrahepatic bile ducts and ductules as detected in mammalian livers, it lacked smooth muscles around bile ducts and portal veins. Extracellular matrices in their connective tissues had thick collagen fibers. Its innervation was restricted to intrahepatic bile ducts and portal veins in the hilum. In livers of other vertebrates, including teleosts, the innervation was broadly detectable, especially around bile ducts, hepatic arteries and portal veins (afferent vessels), but not around central veins (efferent vessels). The chondrichthyans ultrastructurally had smooth muscle tissue around bile ducts. Cilia distribution was confirmed in intrahepatic bile ducts of tetrapods and basal actinopterygians. Teleosts other than osteoglossomorphs lacked cilia in their intrahepatic bile ducts. ConclusionsThe liver architecture of the hagfish may be unique for innervation and extracellular matrices. Hepatic innervation may not have occurred in vertebrate ancestors. Hepatic innervation in bile ducts, hepatic arteries and portal veins may have been conserved among the extant jawed vertebrates. Cilia distribution in bile ducts may have changed during evolution of actinopterygians.

Medically Challenging Case: Lumbosacral Radiculopathy Secondary to Occlusion of Right Iliac Vein Kissing Stent in the Context of Variant Course of Right Iliac Vein between Psoas Muscle and Spine and Factor V Leiden Mutation

Background: The variant course of the right iliac vein between the right psoas muscle and spine and its significance has not been reported and lumbosacral radiculopathy is not a known complication after occlusion of the right iliac vein stent in such condition. Case Report: The patient is a 38-year-old woman with Factor V Leiden mutation, multiple deep vein thrombosis, including in her bilateral iliac veins, and a variant course of the right iliac vein between the psoas muscle and spine, who presented with radicular pain and weakness after stenting of the bilateral iliac veins. She was found to have complete occlusion of the right common iliac through the femoral vein stent that was compressing her lumbosacral spinal roots and resulted in lumbosacral radiculopathy. Her pain and weakness significantly improved after an epidural steroid injection. Conclusion: Lumbosacral radiculopathy is a rare complication after occlusion of the right iliac vein stenting in the setting of a variant course of the right common iliac vein between the psoas muscle and spine and Factor V Leiden mutation. The risks and benefits of implanting a kissing stent in a similar scenario should be weighed carefully for patients at high risk for stent occlusion. Additionally, patients should be assessed for variable anatomy as part of the presurgical workup to hopefully prevent this undesired outcome. Key words: Lumbosacral radiculopathy, iliac vein stenting, Factor V Leiden, deep venous thrombosis, variant course

The course and branching of the extraorgan veins of the organs of urination in the arctic fox

When keeping fur-bearing animals, it is necessary to take into account that these animals have increased motor activity when they are in natural biogeocinosis. Due to the fact that these representatives of fur-bearing animals are kept in conditions of inactivity, this can inevitably lead to changes in the structure of the cardiovascular system. The purpose of the study is to study the features of the course and branching of extraorgan veins of the organs of urination in Arctic foxes, to determine the morphometric data of these vessels. The objects for this study were the corpses of female arctic foxes of two age groups: newborns and three to four months, five in each group. To achieve this task, a set of traditional anatomical research methods was used. According to the results of the study, it was found that the course and branching of the extraorgan vessels of the organs of urination in female arctic foxes is different. The main outflow of blood from the kidneys are the right and left renal veins; from the ureter – the cranial and caudal branches of the ureter; from the tip of the bladder – the cranial cystic vein; from the body and the bottom of the bladder is the caudal cystic vein. It is also necessary to note the close relationship of the organs of urination with the reproductive system, since the left renal vein communicates with the ovarian. In addition, we have established the presence of rare valves in the veins of the ureters and bladder, and the absence of such in the vessels of the kidneys. Thus, based on linear parameters, it can be concluded that the diameter of the veins gradually increases with the growth of the animal, especially by the period of maturation and intensification of organs.