Internal Vein Research Articles

EFFICACY OF COMPLEX DECONGESTIVE THERAPY ON VENOUS FLOW, INTERNAL SAPHENOUS DIAMETER, EDEMA, FAT MASS OF THE LIMBS AND QUALITY OF LIFE IN PATIENTS WITH CHRONIC VENOUS INSUFFICIENCY: A RANDOMIZED CLINICAL TRIAL.

Demonstrate the effectiveness of complex decongestive therapy (CDT) in patients with chronic venous insufficiency (CVI). Asingle-blind randomized controlled trial was conducted, where he participants were subjects with CVI (N= 21/42) that were randomly assigned to an experimental group (N= 11/22) or control group (N=9/18). A treatment of CDT (manual lymphatic drainage (MDL), intermittent pneumatic presotherapy (IPP), bilayer bandage (BB)) was applied to the experimental group for 4 weeks two days per week and no treatment was applied to the control group. The patients were evaluated at baseline (t0), 1 week after finishing the intervention (t1) and 6 weeks after the intervention (t2). The effectiveness of the treatment on symptoms and QoL (haviness, pain and CIVIQ-20 questionary), edema, venous flow (VF) and impedanciometry measurements was evaluated. An improvement in the patient's QoL was observed: there was a decrease in symptoms such as heaviness and pain, an increase in the average velocity of the left femoral vein (LFV) and left internal saphenous vein (LISV), a decrease in the internal saphenous vein diameter (ISVD) in both extremities and a decrease in body mass index and fat mass (FM) in both extremities. These results were maintained when following up at 6 weeks, except for the improvement of QoL. CDT treatment improves the QoL of patients with CVI (CIVIQ-20, VCSS). It also improves symptoms (pain and heaviness), VF velocity (superficial veins [ISV] and deep veins [common femoral vein (CFV), femoral vein (FV), popliteal vein (PV)] and decreases body mass index (BMI), fat mass (FM) and ISVD.

Variants of the Architectonics of the Internal Iliac Vein and Their Applications

The aim was to study the variants of the formation and architectonics of the internal iliac vein (IIV) using postvital and vital methods of research. Material and methods. Typical and atypical variants of the trunk formation, architectonics and skeletotopy of the IIV were studied on the postvital material (n=70) and with the help of three-dimensional modeling of the IIV according to the computer tomographic angiography data (n=400). Results. According to the three-dimensional modeling data, in 90,25% of observations the fusion of the IIV and the external iliac vein (EIV) was typical, when the trunk of the common iliac vein (CIV) was formed. In 9,75% - atypical, when the IIV did not participate in the formation of the trunk of the CIV, but flowed into the opposite CIV, into the confluence of the inferior vena cava, separate trunks of the IIV flowed into the EIV. Based on the evaluation of the whole material under study, the IIV architectonics was typical in 48,3% and atypical in 51,7%. In a typical variant of the IIV architectonics, the main trunk is supplied by the iliolumbar vein (ILV), the posterior trunk is supplied by the superior lateral sacral vein (LSV), superior gluteal vein (SGV), and in the anterior trunk - the obturator vein (OV), lower LSV, internal pudendal vein (IPV) and inferior gluteal vein (IGV). Atypical variants of the IIV architectonics can be divided into 5 groups depending on the peculiarities of the influx of its main tributaries: 1 - atypical influx of the IGV (2,9%), 2 - SGV (2,1%), 3 - OV (16,8%), 4 - ILV (9,9%), 5 - LSV (20%). In 2% of cases anastomoses between IIV and EIV were revealed, in 30,6% - between anterior and posterior trunks of IIV. In the majority of cases, the fusion of the IIV and EIV was located at the level of the first sacral vertebral body, while the fusion of the anterior and posterior trunks of the IIV was at the level of the S1-S2 intervertebral disc. Conclusion. The obtained data should be used when planning and performing surgical interventions on pelvic organs, especially in evisceration.

Leadless pacemaker implantation via the internal jugular vein a promising access for an established intervention

Abstract Background Leadless pacemaker therapy was introduced in 2013 to overcome lead- and pocket-related complications in conventional transvenous pacemaker therapy. These leadless devices are self-contained right ventricular single-chamber pacemakers implanted via a femoral percutaneous approach. However, the femoral route is not always possible due to various reasons. The aim of this analysis is to share our first experience using a jugulary approach for the implantation procedure. Purpose To evaluate safety and feasibility of leadless pacemaker implantation via the internal jugulary vein. Methods The records of the first 34 patients who underwent leadless pacemaker implantation via the right internal jugular venous route at our center were analyzed prospectively. Follow-up period was 3 months. Safety as well as efficacy including electrical parameters of the jugular approach were compared with the data of the first 100 patients who underwent a femoral leadless pacemaker implantation at our center (implanted from 2015-2019). Results Thirty-four patients underwent internal jugular vein leadless pacemaker implantation (mean age, 82.37 ± 7.58, 58.8% males). All leadless pacemakers were implanted successfully. The jugular approach was well tolerated by all patients. Mean procedure time was 33.29 ± 8.81 min with a mean fluoroscopy time of 3.66 ± 2.07 min. The device was positioned at the inferior septum in 11 patients, at the high septum in two and midseptal in 21 patients. The mean pacing threshold was 0.52 ± 0.22 V at 0.24 ms pulse width with a sensed amplitude of 9.13 ± 4.08 mV. There were no complications during the procedure as well as during 3-month follow-up. At follow-up, electrical parameters remained stable in all patients. Conclusion Implantation of a leadless pacemaker via the right internal jugulary vein is a safe and effective alternative to the femoral approach.Patient demographics/device parameterDevice value development over time.

Microscopic internal spermatic-inferior epigastric vein anastomosis for treating left varicocele.

To evaluate the clinical efficacy of microscopic internal spermatic-inferior epigastric vein anastomosis in the treatment of left varicocele and compare it with microscopic spermatic vein ligation for the same condition. A retrospective analysis of 74 patients with left varicocele between July 2020 and July 2022 was performed. The patients were divided into two groups based on the surgical method used. Group A consisted of 37 patients who underwent microscopic internal spermatic-inferior epigastric vein anastomosis, while Group B consisted of 37 patients who underwent microscopic spermatic vein ligation. Comparison of preoperative and postoperative semen quality, reproductive hormone levels, scrotal ultrasound results, duration of surgery, length of hospital stay, postoperative recurrence rate, and occurrence of complications with a follow-up time of 12 mo between two groups. Both groups showed significant improvements in semen quality and serum reproductive hormone levels. The Group A demonstrated significantly improved sperm forward motility compared to Group B, but had longer operation times and hospital stays (P < 0.05). After 1 year of follow-up, 8 partners in Group A and 6 partners in Group B achieved natural conception, with no significant difference between the two groups. There were no recurrences observed in either group during the follow-up period, and no significant statistical differences were found in other postoperative observation indicators. Both microscopic internal spermatic-inferior epigastric vein anastomosis and microscopic spermatic vein ligation are effective surgical methods for treating left varicocele. Anastomosis surgery provides greater improvement in sperm motility, although it is associated with longer operation times and hospital stays.

Surgery for Pineal Region Tumors: Concept and Technical Aspects of Occipital Transtentorial Approach

This article describes the concept and technical aspects of the occipital transtentorial approach(OTA)for tumor extraction in the pineal region, based on the author's experience and literature review. Awareness of the successful completion of each surgical step is essential. Preoperative preparation and imaging evaluations, with particular attention to the veins and venous sinuses, are especially important. It is also helpful to perform a complete dura incision and inversion up to the edge of confluence, superior sagittal sinus, and transverse sinus. Subsequently, it is necessary to understand the usefulness of adequate dissection in the vicinity of the corpus callosum and internal occipital vein(IOV)so that the occipital lobe can be moved without difficulty. Furthermore, development of the IOV with adequate tentoriotomy facilitates contralateral work. Finally, complete understanding of each step during the bilateral, ambient cistern and cerebellomesencephalic fissure dissection process, where the cerebellar vermis can be moved without difficulty, is necessary for a safe OTA to pineal region tumor extraction.

Sub-gluteal ligation of the internal pudendal vein for management of veno-occlusive erectile dysfunction (Shaeer's Vein Ligation-I): the cadaveric study.

Vein ligation for veno-occlusive erectile dysfunction is being abandoned due to the recurrence rate. Among the reasons for failure is inability to ligate the deep system of veins; the internal pudendal vein. The vein exits the pelvis in the gluteal region, from the lesser sciatic foramen to the greater sciatic foramen, coursing over the ischial spine and sacro-spinous ligament, under the gluteus maximus. This work aims to verify feasibility of the first surgical procedure to ligate the internal pudendal vein through the gluteal approach. This cadaveric study involved five formalin-fixed cadavers. A surface anatomical landmark was designed to identify the ischial spine, at the intersection of two lines: a vertical line from posterior superior iliac spine to ischial tuberosity, and a horizontal line extending from sacro-coccygeal joint, laterally. An incision is cut encompassing the target point. Subcutaneous fat is dissected down to the gluteus maximus, which is split along the direction of its fibers. The vein can be found crossing over the ischial spine. "Shaeer's Vein Ligation - I" appears to be surgically feasible. A protocol for a surgical study is registered at clinicaltrials.gov, and is open for participation.

Factors Associated with the Evolution of Superficial Vein Thrombosis and Its Impact on the Quality of Life: Results from a Prospective, Unicentric Study

Background: Superficial venous thrombosis (SVT) is a common clinical condition caused by inflammation and the presence of a thrombus inside a superficial vein. It has traditionally been considered a benign and banal disorder, although it can progress or can be associated with thromboembolic disease of deep territories in up to 20%, asymptomatic or symptomatic pulmonary embolism (PE), especially if it affects the main trunk of the internal saphenous vein. The impact of deep vein thrombosis on the quality of life and its sequelae have long been described in the literature; however, they have not been studied in superficial vein thrombosis. Objectives: We aimed to evaluate the risk factors, management, and complications of SVT and its impact on the quality of life of our patients. Methods: Observational, prospective, single-center study to evaluate the management of SVT. The ultrasound (US) was performed initially on symptomatic patients, during treatment with low-molecular-weight heparin (LMWH), at a follow-up, and at the end of 45 days of treatment. A quality-of-life questionnaire was administered to determine the risk factors, management, and complications of SVT at the moment of diagnosis and at the end of treatment. We included patients referred from the emergency department to a monographic consultation for thromboembolic disease, over 18 years of age with a diagnosis of acute SVT symptomatic, without contraindication to initiate anticoagulation. Results: In total, 63 patients were evaluated between October 2020 and April 2022. The mean age was 65.8 years (SD 13.5), of which 35 were women (55.6%), 39 presented cardiovascular risk factors (61.9%), 25 had a history of previous personal venous thromboembolism (VTE) (39.7%), and 10 had obesity (15.9%), 47 had chronic venous insufficiency or varicose veins (74.9%). During follow-up with ultrasound, 39.7% had partial revascularization, and at discharge, 63.5% had permeabilized the thrombosis against 19% who had residual thrombosis or progression of thrombosis. There was a positive correlation between mobility parameters and improvement in the performance of daily activities (rho = 0.35; p = 0.012) and with improvement in pain/discomfort (rho = 0.37; p = 0.007). An improvement in pain parameters was statistically significantly related to a global assessment health perception (rho = 0.48; p &lt; 0.001). Anxiety and depression parameters were related to a global assessment health perception (rho = 0.462; p = 0.001) and to an overall improvement at 12 months (rho = 0.45; p = 0.001). CONCLUSIONS: Superficial venous thrombosis (SVT) is a highly prevalent disease, which is traditionally considered banal and has good evolution, with heterogeneous management in clinical practice and limited information on patient selection for therapies, current treatment routes, and drug use, as well as outcomes. In recent years, the importance of this entity has become evident due to its frequency in clinical practice, its risk of complications, and the impact it has on the quality of life. This study’s results emphasize the importance of the diagnosis, treatment, and follow-up of superficial venous thrombosis.

High‐Performance NIR Emission in Chromium‐Doped Garnet Phosphors Enabled by Structure and Excitation Regulation

AbstractThe burgeoning phosphor‐converted near‐infrared light‐emitting diodes (pc‐NIR LEDs) have important applications in special illumination and spectroscopy analysis. However, the development of efficient NIR‐emitting phosphors with high performance is still a challenge. In this work, a chemical unit co‐substitution strategy is proposed to realize the excitation transition regulation and successfully achieve high‐performance NIR luminescence in Ca3‐yNayMg1‐ySb2‐xAl2+yO12: xCr3+ (0 ≤ x ≤ 0.05, 0 ≤ y ≤ 1) garnet‐type solid solution phosphors. Through the excitation transition modulation from the 4A2 ground state to the 4T1(4P) and 4T1(4F) excitation state, the excitation intensity at the blue light region is largely enhanced by 25.6 times. Moreover, the NIR‐emitting efficiency and thermal stability are improved, with the optimal luminescence internal quantum efficiency of 90.6% and thermal stability of 97%@423 K, without any flux‐assisted sintering or reduction atmosphere protection. The structure regulation induced small Stokes shift, weak electron‐phonon coupling effect, and decreased non‐radiative transition are responsible for the excellent NIR‐emitting performance. Finally, the NIR pc‐LED is fabricated with photoelectric efficiencies of 18.7%@100 mA and NIR output powers of 63 mW@100 mA, presenting potential applications in nondestructive internal defect detection, veins imaging, and night vision surveillance.

Skeletotopy of the caudal vena cava of Yorkshire piglets

The venous system of animals always arouses a certain interest among veterinary specialists. On the one hand, there are issues related to comparative anatomy in different animal species, and on the other hand, there is a practical interest put forward by veterinary surgeons and clinicians. First of all, it is certainly the valve apparatus of this system, which gives reason to believe that the valves of the veins not only direct the movement of blood through the venous vessels, but also contribute to balancing the blood pressure in the entire cardiovascular system. The purpose of our study is to study the skeletotopy of the caudal vena cava of Yorkshire piglets, to give anatomical and topographic characteristics of veins, to carry out morphometry of main collectors. To study the branching of the caudal vena cava of Yorkshire piglets, ten corpses aged 28-30 days of life were obtained, which were delivered from the pig breeding complex to the Department of Animal Anatomy of the St. Petersburg State University of Veterinary Medicine. During the study, such methods as: fine anatomical dissection, vasorentgenography, morphometry, photographing were used. As a result of our study, skeletotopy of the caudal vena cava of Yorkshire piglets with anatomical and topographic characteristics of veins was established and morphometry of the main collectors was performed. The topography of the iliac veins in Yorkshire piglets has certain patterns associated with the conditions of maintenance and movement. No valves were found in the common iliac vein, which ensures the outflow of blood from the parietal and visceral branches. A large number of anastomoses were established between the circumferential deep iliac, gluteal and internal sacral veins.

Anatomical Validation of Internal Iliac Vessels Assessed by Three-dimensional Angiographic Analysis.

Anatomical understanding of the internal iliac vessels is important with the increasing frequency of minimally-invasive pelvic surgery. We aimed to investigate the branch patterns of internal iliac vessels, especially the veins. This study included 30 patients with 60 half-pelvises who underwent minimally-invasive pelvic surgery. Branch patterns were assessed on surgical videos with a multi-detector computed tomography-based three-dimensional simulation. Branch patterns of the superior gluteal artery and vein (SGA and SGV), inferior gluteal artery and vein (IGA and IGV), internal pudendal artery and vein (IPA and IPV), and obturator artery and vein (ObA and ObV) were investigated. In the most frequent internal iliac vein (IIV) branch pattern, 67% of SGV branched from the IIV, 95% of the IGV branched from the IPV and 82% of the ObV branched from the IPV. According to Adachi's classification, 62% of IIVs were Type I and 33% Type IV. Although IIV branch patterns are heterogeneous, in individual patients with the most frequent branch patterns, good correlation (75-100%) of the branch patterns was observed between the internal iliac artery (IIA) and IIV, and between the right and left IIVs. This study clarified the branch patterns of IIV. In patients with the most frequent branch patterns, good correlation of the branch patterns was observed between the IIA and IIV, and between right and left IIV. We believe this helps secure the safety and standardization of minimally-invasive pelvic surgery.

Transverse Canal Foramen and Pericarotid Venous Network in Metatheria and Other Mammals

Transverse Canal Foramen and Pericarotid Venous Network in Metatheria and Other Mammals

Successful Treatment of Intractable Rectal Varices with Gelfoam Slurry Embolisation and Coiling.

Rectal varices are an infrequent outcome of portal hypertension formed by portocaval anastomosis between the superior rectal vein with the inferior mesenteric vein of the portal system upstream, and the middle and inferior rectal vein draining into the internal iliac and internal pudendal vein of the systemic circulation, respectively. Portal system variations are extremely rare.Most common modality of recurrent rectal varices bleed is a transhepatic intrajugular portosystemic shunt. The absolute contraindications to this include congestive heart failure among others.In the presence of multiple co-morbidities and contraindication for TIPS, various interventional radiological modalities on a case-by-case basis are available including percutaneous transhepatic rectal varices obliteration.

Brittle failures and vein formation in the evolution of the South Qiangtang accretionary complex in the Tibetan Plateau

The genesis of the subduction mélange in the central Qiangtang terrane has been a long hot debate. However, little research has been conducted on the brittle failure within the accretionary wedge, which is very important to unveil the structural evolution of the mélange. In this study, based on the recognition of multiple deformational phases, we analyse the characteristics and formation history of the vein system in the Gangma Co mélange. Six groups of quartz veins are recognized. Foliation‐parallel extension veins (G1 veins), shear veins (G2 veins) and foliation‐perpendicular extension veins (G4 veins) are supposed to have formed during the subduction of oceanic crust, recording the repeated low‐angle thrust‐sense frictional sliding, tensile fracturing and stress changes generated by subduction‐related earthquakes. Subsequent vertical extension veins (G5 veins) are suggested to be related to the exhumation of the underplated mélange, while the horizontal extension veins (G6 veins) in the last phase represent the final horizontal thrusting. The temperature conditions for shear vein formation were examined by fluid inclusion analysis, ranging from 120 to 200°C, coinciding with the temperature conditions of the slow earthquake region where episodic tremors and slow slip occur. This contribution supports that the Gangma Co mélange represents an in situ subduction zone and that its internal vein system is a response to the tectonic evolution of the Longmu Co‐Shuanghu Tethys Ocean.

Tactile, Orientation, and Optical Sensor Fusion for Tactile Breast Image Mosaicking

Breast cancer screening using tactile imaging (TI) is an advancing field of low-cost noninvasive medical imaging. Utilizing arrays of capacitive pressure transducers to perform a differential stress measurement of suspicious tissue, TI has been shown to be effective in measuring lesion size and stiffness, and subsequent differentiation of malignant and benign conditions, in repeated clinical studies. In order to further improve the lesion classification accuracy of clinical TI, this article presents a novel method of mosaicking tactile images to form a large composite tactile map using the vein structure within the breast to spatially register tactile data. This article demonstrates practical nonrigid tactile image mosaicking, using probe contact force and relative orientation sensor fusion to correct for the tissue deformation during tactile scanning, miniaturized and applied to a pre-clinical TI prototype. Testing of the proposed TI prototype on representative, tissue-mimicking, and silicone breast phantoms, with varying baseline elasticity and internal vein structure, yields typical image registration accuracies of 0.33% ± 0.15%. In similar testing, the proposed system measures the background elasticity of the samples with worst case error < 4.5% over the range of 9–60 kPa, required for accurate lesion characterization. This work will lead into further clinical validation of TI for measurement and classification of in situ phantom and breast lesions, utilizing the delivered metrics from this work to improve differentiation accuracy.

Rate of saphenous vein occlusion and side effects at 1 year follow up after 1470 nm endolaser.

Use of endolaser for chronic venous disease involves choosing the laser wavelength and optical fiber to use and the quantity of energy to be administered. Efficacy is assessed by the venous occlusion rate and safety is evaluated in terms of side effects. To determine the incidence of total post-endolaser saphenous vein occlusion at 1-year follow-up. To describe side effects and their incidence and rates of reintervention or supplementary treatment during the postoperative period. A retrospective, observational cohort study with a quantitative approach, enrolling patients with saphenous vein incompetence treated with intravenous 1,470 nm laser ablation. Data were input to an MS Excel 2019 spreadsheet, calculating means and standard deviations with the software's Power Query supplement. 38 patients and 104 venous segments were eligible for the study. 100% were occluded at 30 days and 99.04% were still occluded at 1 year after the procedure. Mean Linear Endovenous Energy Density administered to the internal saphenous vein was 2,040.52 W/cm/s with standard deviation of ± 1,510.06 W/cm/s and 1,168.4 W/cm/s with standard deviation of ± 665.011 W/cm/s was administered to the external saphenous vein. Pain along the saphenous path was the most common side effect, with eight cases (21.05%), followed by one case of paresthesia (2.63%). The total occlusion rate at 1-year follow-up suggests the technique is promising and is currently applicable in this sample. The incidence of pain and paresthesia may be caused by the high mean energy delivered in some cases. It is recommended that multicenter studies be conducted with larger and more uniform samples in terms of their Clinical-Etiological-Anatomical-Pathological classifications.

Priapism and pyrexia of unknown origin presenting as a relapse of multiple myeloma

Pyrexia of unknown origin (PUO) is defined as a body temperature &gt;38.3°C on several occasions for &gt;3 weeks with failure of diagnosis despite one week of inpatient investigations or three outpatient visits. Aetiology for PUO may be infective, inflammatory, autoimmune, malignant, miscellaneous or remains undiagnosed. We describe a patient diagnosed with multiple myeloma (ISS-stage II) who completed induction chemotherapy and presented with PUO and extensive thrombosis as a complication of relapsed myeloma (very rare; 0.2% in myeloma). A 62-year-old man, with diagnosed multiple myeloma, achieved a very good partial remission after 6 cycles of bortezomib-thalidomide-dexamethasone regimen, presented with PUO and right lower limb deep vein thrombosis. His thrombosis was managed successfully with anticoagulation. While on therapeutic anticoagulation with warfarin and being investigated extensively for PUO without a focus, he developed priapism due to bilateral internal pudendal vein thrombosis. His anticoagulation was intensified to a target INR of 2.5-3.5. He recovered without residual damage. Despite broad spectrum antimicrobial agents, trial of antimalarial and anti-tuberculosis treatment, he remained pyrexial with rising inflammatory markers (ESR, CRP). Relapsed multiple myeloma was confirmed with 30% bone marrow plasma cells and raised serum monoclonal para-protein levels of 23.78g/L. He was restarted on chemotherapy with bortezomib-lenalidomide-dexamethasone. His PUO of two months subsided with one week of chemotherapy.&#x0D; This case illustrates an atypical presentation of relapsed myeloma and highlights the importance of achieving early diagnosis with a systematic approach and making optimum treatment choice after careful evaluation of previous treatment, drug toxicities, patient’s condition and available treatment options.

Value of internal juguler vein distensability and carotid artery Doppler in assessment of fluid responsiveness in sever sepsis and septic shock patients

Value of internal juguler vein distensability and carotid artery Doppler in assessment of fluid responsiveness in sever sepsis and septic shock patients

A Novel System and Experimental Study for 3D Finger Multibiometrics

Fingers contain various discriminative biometric traits, such as fingerprint, finger vein, finger knuckle, finger shape, and so on, which are complementary in identity information. However, only one or a few traits are used in most current research and practical applications, while others are ignored, resulting in degraded recognition performance and vulnerability to forgery. In this paper, we make the first attempt to collect and study all biometric traits on the finger. Firstly, a novel multi-view, multi-spectral 3D finger imaging system is proposed. To the best of our knowledge, it is the first biometric imaging system capable of capturing almost all finger-based traits. We scanned numerous fingers with this 3D finger imaging system, obtaining external skin images and internal vein images from 6 different views. The proposed 3D finger reconstruction and texture mapping algorithms are then used to generate 3D finger models with skin and vein textures. Second, we establish a benchmark dataset, namely the Large-scale Finger Multi-Biometric database and benchmark for 3D Finger Biometrics (LFMB-3DFB). The LFMB-3DFB contains 695 fingers, and each finger is acquired 10 times, yielding 6 finger skin images and 6 finger vein images for a total of 83,400 images and 6,950 3D finger models. Finally, we design a more scientific and comprehensive evaluation protocol to conduct extensive experimental research and analysis on this database for both subject-independent verification and subject-independent close-set identification tasks. Comprehensive and rigorous experiments for 2D finger traits recognition, multi-view finger traits recognition, 3D finger traits recognition, and score-level fusion on LFMB-3DFB are carried out, and excellent results are achieved. The LFMB-3DFB database will be released at <uri xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">https://github.com/SCUT-BIP-Lab/LFMB-3DFB</uri> to promote 3D finger multi-biometric research using cutting-edge imaging techniques.

Three underdogs among galenic veins: anatomical analysis and literature review of surgical relevant veins in the quadrigeminal cistern.

Recent studies (Alaou-Ismaili et al. 2020; Kilic et al. Eur J Radiol 56:212-219, 2005) among experienced sub-specialized neurosurgeons described divergent perceptions of surgical risk for venous sacrifice in posterior fossa surgery. Three galenic veins stood out as controversial in venous risk assessment and underexplored in the literature: the internal occipital vein (IOV), the precentral cerebellar vein (PCV), and the superior vermian vein (SVV). We have conducted a narrative review based on a systematic literature search to analyze terminology and anatomic descriptions and to suggest a coherent synthesis of published data on these veins. A systematic PubMed literature search was carried out using the keywords: "posterior fossa," "venous anatomy," and "radiology." Relevant radiological, microsurgical, and anatomical articles were selected if they described the anatomy of the three veins. Anatomical descriptions were analyzed with hermeneutic methodology alongside the articles' radiological and anatomical dissection pictures. New illustrations were created to depict the synthesized image of the venous anatomy. A total of 13 articles described the anatomy and terminology of the relevant veins. The descriptions of the IOV included smaller non-occipital vessels that confused the identification of the vessel. IOV is analyzed to be the vein draining the primary visual cortex, which drains into the vein of Galen (VG). The PCV and SVV enter the VG from below and are fused in almost half of all studied patients, creating a third vessel by the name of the superior cerebellar vein. A conscientious narrative review and hermeneutic analysis produced a synthesized, uniform picture of terminology and anatomy. Consensus on anatomical descriptions and definitions are indispensable for validation of anatomy, research into anatomical variation, for surgical planning and documentation.

Venous blood supply of the lateral ventricles of the brain. Clinical observations

Surgical treatment of tumors of the lateral ventricles is a complex problem in neurooncology. Tumors of the lateral ventricles account for 1–2 % of all brain neoplasms. Practical neurosurgeons are faced with the treatment of such patients, despite their rarity. One of the successful results of the treatment of patients with tumors of the lateral ventricles is good knowledge of the anatomy, including the blood supply of these tumors. One of the important problems that neurosurgeons face when removing tumors of the lateral ventricles is the condition of the internal veins. Quite frequently the veins are included in the structure of the tumor. If the veins are damaged, a violation of the venous outflow occurs, which leads to the development of complications in the form of edema, and in some cases, dislocation of brain structures. Therefore, knowledge of venous anatomy and its changes in the presence of tumors of the lateral ventricles before surgery is of great importance for the successful surgery of tumors of the lateral ventricles. The proposed article is devoted to the venous anatomy of the lateral ventricles. The presented clinical observation demonstrates the correct examination of patients with neoplasms of the lateral ventricles.