Primary Veins Research Articles

Surgical Technique of Endovascular Ablation for Primary Lower Extremity Varicose Veins: Ablation Catheter Subcutaneous Puncture to Extend the Ablation Length

Surgical Technique of Endovascular Ablation for Primary Lower Extremity Varicose Veins: Ablation Catheter Subcutaneous Puncture to Extend the Ablation Length

Quercus zhekunii M.Deng & J.Huang, a new sclerophyllous oak from Guangxi, southwest China

Asian (sub)tropical karst regions harbor high endemism and species diversity of sclerophyllous oaks. In this study, Quercus zhekunii, a new species from Guangxi, China, is described and illustrated. Phylogenomic reconstruction using RAD‐seq placed this new species within the ‘Tropical clade' of Quercus sect. Ilex. The dense fused fasciculate and uniserate trichomes on the leaf abaxial surface of Q. zhekunii resemble those of Q. kingiana. However, its distinctively concave primary and lateral veins on the leaf adaxial surface, along with the prominent backward‐recurved leaf blade and leaf margin, make it morphologically distinct from any known species in Q. sect. Ilex. The conservation status of Q. zhekunii is assessed as ‘Endangered' (EN). A new identification key to the species in the ‘Tropical clade' is provided. In addition, character evolution and phylogeography of the ‘Tropical clade' of Q. sect. Ilex is briefly discussed based on the new phylogenetic and morpho‐anatomical data.

Transcriptome sequencing-based analysis of primary vein development in Betula pendula ‘Dalecarlica’

Keymessage The study revealed the major biological processes occurred at three developmental stages and identified candidate genes involved in primary vein development of birch plants.Vascular tissues usually mirror the surrounding leaf shape and its development plays a fundamental role in plant performance. However, the information of vascular development in birch trees, especially primary vein development, remains unclear. Therefore, we conducted the anatomical observation on primary veins from leaves at different development stages in Betula pendula ‘Dalecarlica’. With the development of primary vein, dynamic changes in mechanical tissue thickness and primary vein diameter were consistent with each other, and the sum of phloem, xylem and cambium thickness was significantly varied. Transcriptome analysis indicated that primary vein development could be divided into three stages, namely Stage I, II and III, which were in aggreement with anatomical observation. Expression of marker genes associated with vascular tissues revealed that pro-vasculature development occurred at Stage I and II, and phloem development occurred at Stage III. GO enrichment analysis of differentially expressed genes (DEGs) showed that shared DEGs at Stage II were mainly engaged in cell division and cell cycle, and shared DEGs at Stage III were mainly engaged in phosphorylation. Decreased cell division and cell cycle as well as activation of lignin biosynthesis might contribute to primary vein development. Combining phenotypic traits, we performed weighted gene co-expression network analysis and identified a cytochrome P450 84A (CYP84A) family gene (BpF5H1). Based on analyses of gene families, expression patterns and yeast-two hybrid assay results, we proposed a potential electron transfer pathway involving BpF5H1 and three cytochrome b5 proteins during primary vein development in B. pendula ‘Dalecarlica’. These results could shed some light on which biological processes occurred during primary vein formation and provide some valuable clues for vascular morphogenesis in woody plants.

A new species of Phyllanthus (Phyllanthaceae) hiding in the shades in an urban Atlantic Forest in Rio de Janeiro State, Brazil

A new and critically endangered species of Phyllanthus, endemic to the Parque Nacional da Tijuca in Rio de Janeiro State, Brazil, is described and illustrated here. Phyllanthus celatus is placed in Phyllanthus subgenus Phyllanthus section Phyllanthus subsection Phyllanthus. Morphologically it resembles P. augustinii, P. lobatus and P. niruri, but differs mainly by presenting reddish primary, secondary and intersecondary veins on the abaxial surface (vs absent in both species), and 5-lobed pistillate disc (vs entire only in P. augustinii and P. niruri). Of these, only P. lobatus has a lobed disc, but it differs in pistillate sepals light green (vs whitish or slightly pinkish), deeply 5-lobed pistillate glandular disc (vs 3–5-lobed), styles erect (vs curved), and geographic distribution restricted to the Southeast (vs South). The systematic position of this species and its morphological relationships with allies are discussed and field photographs, illustrations, a distribution map, preliminary conservation status, and taxonomic notes are provided.

Ultra-low-field magnetic resonance angiography at 0.05 T: A preliminary study.

We aim to explore the feasibility of head and neck time-of-flight (TOF) magnetic resonance angiography (MRA) at ultra-low-field (ULF). TOF MRA was conducted on a highly simplified 0.05 T MRI scanner with no radiofrequency (RF) and magnetic shielding. A flow-compensated three-dimensional (3D)gradient echo (GRE) sequence with a tilt-optimized nonsaturated excitation RF pulse, and a flow-compensated multislice two-dimensional (2D) GRE sequence, were implemented for cerebral artery and vein imaging, respectively. For carotid artery and jugular vein imaging, flow-compensated 2D GRE sequences were utilized with venous and arterial blood presaturation, respectively. MRA was performed on young healthy subjects. Vessel-to-background contrast was experimentally observed with strong blood inflow effect and background tissue suppression. The large primary cerebral arteries and veins, carotid arteries, jugular veins, and artery bifurcations could be identified in both raw GRE images and maximum intensity projections. The primary brain and neck arteries were found to be reproducible among multiple examination sessions. These preliminary experimental results demonstrated the possibility of artery TOF MRA on low-cost 0.05 T scanners for the first time, despite the extremely low MR signal. We expect to improve the quality of ULF TOF MRA in the near future through sequence development and optimization, ongoing advances in ULF hardware and image formation, and the use of vascular T1 contrast agents.

Universal Hyperuniform Organization in Looped Leaf Vein Networks.

The leaf vein network is a hierarchical vascular system that transports water and nutrients to the leaf cells. The thick primary veins form a branched network, while the secondary veins can develop closed loops forming a well-defined cellular structure. Through extensive analysis of a variety of distinct leaf species, we discover that the apparently disordered cellular structures of the secondary vein networks exhibit a universal hyperuniform organization and possess a hidden order on large scales. Disorder hyperuniform systems lack conventional long-range order, yet they completely suppress normalized infinite-wavelength density fluctuations like crystals. Specifically, we find that the distributions of the geometric centers associated with the vein network loops possess a vanishing static structure factor in the limit that the wave number k goes to 0, i.e., S(k)∼k^{α}, where α≈0.64±0.021, providing an example of class III hyperuniformity in biology. This hyperuniform organization leads to superior efficiency of diffusive transport, as evidenced by the much faster convergence of the time-dependent spreadability S(t) to its longtime asymptotic limit, compared to that of other uncorrelated or correlated disordered but nonhyperuniform organizations. Our results also have implications for the discovery and design of novel disordered network materials with optimal transport properties.

Leaf morphological variation in Betula medwediewii Regel populations from Türkiye

Leaf variations of Betula medwediewii in Türkiye with respect to its distribution pattern were studied because this plant taxon is a Euxine element and a distinct relict species in Türkiye. In this context, the aim of this study is to investigate variations in leaf morphological characteristics within and among B. medwediewii populations in natural distribution areas in Türkiye. Thus, the morphological leaf characteristics of four populations of B. medwediewii growing at different elevations spanning from 1472 to 2065 m.a.s.l in two cities (Artvin and Rize) and four boroughs (Arhavi, Borçka, Murgul, and Çamlıhemşin) of Türkiye were analyzed. The four populations were selected based on their natural distribution and 1,200 leaf samples belonging to 40 individuals were measured with ImageJ. According to the results of correlation analysis, statistically significant relationships were determined among morphological leaf characteristics. Mean values for petiole length (1.16 cm), leaf width (5.11 cm), leaf length (7.96 cm), length of lamina (6.79 cm), leaf area (26.62 cm²), leaf vein angle (54.21°), and number of primary leaf veins (20.03) were determined in all populations. Because B. medwediewii contributes to biodiversity and can preserve the ecological stability of the Turkish forest area, its conservation is crucial.

Effects of particle size on toxicity, bioaccumulation, and translocation of zinc oxide nanoparticles to bok choy (Brassica chinensis L.) in garden soil

The indiscriminate use of zinc oxide nanoparticles (ZnO NPs) in daily life can lead to their release into soil environment. These ZnO NPs can be taken up by crops and translocated to their edible part, potentially causing risks to the ecosystem and human health. In this study, we conducted pot experiments to determine phytotoxicity, bioaccumulation and translocation depending on the size (10 – 30 nm, 80 – 200 nm and 300 nm diameter) and concentration (0, 100, 500 and 1000 mg Zn/kg) of ZnO NPs and Zn ion (Zn2+) in bok choy, a leafy green vegetable crop. After 14 days of exposure, our results showed that large-sized ZnO NPs (i.e., 300 nm) at the highest concentration exhibited greater phytotoxicity, including obstruction of leaf and root weight (42.5 % and 33.8 %, respectively) and reduction of chlorophyll a and b content (50.2 % and 85.2 %, respectively), as well as changes in the activities of oxidative stress responses compared to those of small-sized ZnO NPs, although their translocation ability was relatively lower than that of smaller ones. The translocation factor (TF) values decreased as the size of ZnO NPs increased, with TF values of 0.68 for 10 – 30 nm, 0.55 for 80 – 200 nm, and 0.27 for 300 nm ZnO NPs, all at the highest exposure concentration. Both the results of micro X-ray fluorescence (μ-XRF) spectrometer and bio-transmission electron microscopy (bio-TEM) showed that the Zn elements were mainly localized at the edges of leaves exposed to small-sized ZnO NPs. However, the Zn elements upon exposure to large-sized ZnO NP were primarily observed in the primary veins of leaves in the μ-XRF data, indicating a limitation in their ability to translocate from roots to leaves. This study not only advances our comprehension of the environmental impact of nanotechnology but also holds considerable implications for the future of sustainable agriculture and food safety.

Inversion of Asymmetric Vortex Vein Dilatation in Pachychoroid Spectrum Diseases

PurposeIntervortex venous anastomosis is widely recognized as compensating for vortex vein congestion in pachychoroid spectrum diseases. However, determining the blood flow direction within the compensated drainage route is often challenging. Herein, we investigated the morphological patterns of vortex veins in eyes showing retrograde pulsatile vortex venous flow. DesignRetrospective observational case series. Subjects689 consecutive eyes with treatment-naïve central serous chorioretinopathy, pachychoroid neovasculopathy, or polypoidal choroidal vasculopathy. MethodsWe reviewed the clinical records of patients with these pachychoroid spectrum diseases. Multimodal images including indocyanine green angiography (ICGA) and en face optical coherence tomography were analyzed. Main Outcome MeasuresIntervortex venous anastomosis between superotemporal and inferotemporal vortex veins and the dominant site of dilated temporal vortex veins were determined in the eyes with retrograde pulsatile vortex venous flow in the temporal vortex veins. Results22 eyes with retrograde pulsatile vortex venous flow in the temporal vortex veins were identified utilizing early-phase ICGA videos. In 9 eyes, retrograde pulsatile flow was detected in the superotemporal vortex veins which were connected to the inferotemporal vortex veins via intervortex venous anastomoses. Among these cases, contralateral inferotemporal vortex vein dilatation was dominant in 7 eyes (77.8%), while superotemporal and inferotemporal vortex veins were symmetrically dilated in the other 2 eyes (22.2%). On the other hand, in 13 eyes, the retrograde pulsatile flow was detected in the inferotemporal vortex veins which were linked to the superotemporal vortex veins via intervortex venous anastomoses. In these eyes, contralateral superotemporal vortex vein dilatation was dominant in 10 eyes (76.9%). Superotemporal and inferotemporal vortex veins were symmetrically dilated in 2 eyes (15.4%), while mainly inferotemporal vortex veins were dilated in 1 eye (7.7%). ConclusionsIn pachychoroid spectrum diseases, there are cases wherein congested venous blood might drain into the contralateral vortex veins via intervortex anastomoses. Overloaded contralateral vortex veins may, as a consequence, become more dilated than the primary congested vortex veins. Inversion of asymmetric vortex vein dilatation might thereby develop in pachychoroid spectrum diseases.

A new Spathiphyllum (Araceae) from Mexico segregated by its morphology and floral scent from closely related species

AbstractSpathiphyllum is a mostly Neotropical genus of the Araceae plant family. Many species have a long flowering period and emit a strong, pleasant, and species‐specific floral scent. In Mexico, Spathiphyllum is represented by 14 species, 9 of which are endemic. Here, we describe the morphology, floral scent composition, and flowering phenology of a hitherto unknown species, S. hentrichianum sp. nov. This species is characterized by having a petiole not sheathed to the geniculum, leaf blades with less than 25 primary lateral veins per side, 1–2 ovules per locule, and 3–5 ovules per ovary. The strong scent consists of various terpenes and aromatic compounds, mainly (E,E)‐α‐Farnesene, (E)‐Cinnamyl acetate and (E)‐Cinnamyl alcohol. The new species is morphologically similar to S. cochlearispathum, but the latter differs in having a petiole sheathed to the geniculum, leaf blades with up to 31 primary lateral veins per side, 2–6 ovules per locule and 6–16 ovules per ovary, and the floral scent is also different between both species. In S. cochlearispathum, the scent is dominated by aromatic compounds, one terpene and one nitrogen‐containing compound, such as Methyl salicylate, Methyl p‐anisate, Methyl (E)‐cinnamate, (R)‐Linalool and 2‐Phenylacetonitrile. The flowering cycle of an inflorescence in S. hentrichianum lasted between 25 and 29 days. We suggest that detailed volatile organic compounds in the floral scent could be useful when defining a new taxon, especially among cryptic and sympatric aroid species.

A Study of Blood Viscosity and Inflammatory Biomarkers’ Levels in Bilateral Primary Varicose Veins/Reticular Veins as Predictive Markers

Objectives Cross-sectional data was collected for a period of 1 year to assess the biomarkers of inflammation, and blood viscosity as predictive markers in patients with primary bilateral varicose veins or reticular veins that might progress to varicose veins. Material and Methods A sample of 40 participants, 20 controls and 20 patients aged 18–65 years falling under the reticular veins and symptomatic varicose veins (C1, 2s), primary etiology (Ep), superficial veins (As), reflux pathology (Pr) categories of Clinical, etiologic, anatomic, Pathophysiologic (CEAP) classification with the exception of telangiectatic veins, were included in the study. Blood viscosity was measured using a Capillary Viscometer. Evaluated inflammatory markers were tissue Plasminogen Activator (tPA), Plasminogen Activator Inhibitor-1 (PAI-1), and fibrinogen. Analysis was done using Statistical Package for the Social Sciences (SPSS) software and Chi-square, Fisher’s, Bonferroni, and Analysis of Variance (ANOVA) tests were applied. Results There was a statistically insignificant relationship between occupation and different study groups. Standing hours and serum fibrinogen levels had a significant difference in different study groups. Serum tPA, Serum PAI-1, and blood viscosity had an insignificant difference between different study groups. It was revealed that the pairwise group comparisons of study group C2 vs. control group C0, study group C1 vs. control group C0 and study group C2 vs. study group C1, and study group C2 vs. control group C0 each were significantly different pairwise. Conclusion Blood viscosity, tPA and PAI-1 cannot be used as predictive markers in patients with bilateral (B/L) primary varicose veins/reticular veins. Serum fibrinogen levels can be used as predictive markers for the development of B/L primary varicose veins and in our particular study with a predictive range of 189.4–327.9 mg/dL but not for B/L reticular veins. Prolonged standing, irrespective of the occupation of the patient, is associated with the development of B/L reticular veins and B/L varicose veins.

Mechanosensation in leaf veins.

Whether the plant vasculature has the capacity to sense touch is unknown. We developed a quantitative assay to investigate touch-response electrical signals in the leaves and veins of Arabidopsis thaliana. Mechanostimulated electrical signaling in leaves displayed strong diel regulation. Signals of full amplitude could be generated by repeated stimulation at the same site after approximately 90 minutes. However, the signals showed intermediate amplitudes when repeatedly stimulated in shorter timeframes. Using intracellular electrodes, we detected touch-response membrane depolarizations in the phloem. On the basis of this, we mutated multiple Arabidopsis H+-ATPase (AHA) genes expressed in companion cells. We found that aha1 aha3 double mutants attenuated touch-responses, and this was coupled to growth rate reduction. Moreover, propagating membrane depolarizations could be triggered by mechanostimulating the exposed primary vasculature of wild-type plants but not of aha1 aha3 mutants. Primary veins have autonomous mechanosensory properties which depend on P-type proton pumps.

Wound-response jasmonate dynamics in the primary vasculature.

The links between wound-response electrical signalling and the activation of jasmonate synthesis are unknown. We investigated damage-response remodelling of jasmonate precursor pools in the Arabidopsis thaliana leaf vasculature. Galactolipids and jasmonate precursors in primary veins from undamaged and wounded plants were analysed usingMS-based metabolomics and NMR. In parallel, DAD1-LIKE LIPASEs (DALLs), which control the levels of jasmonate precursors in veins, were identified. A novel galactolipid containing the jasmonate precursor 12-oxo-phytodienoic acid (OPDA) was identified in veins: sn-2-O-(cis-12-oxo-phytodienoyl)-sn-3-O-(β-galactopyranosyl) glyceride (sn-2-OPDA-MGMG). Lower levels of sn-1-OPDA-MGMG were also detected. Vascular OPDA-MGMGs, sn-2-18:3-MGMG and free OPDA pools were reduced rapidly in response to damage-activated electrical signals. Reduced function dall2 mutants failed to build resting vascular sn-2-OPDA-MGMG and OPDA pools and, upon wounding, dall2 produced less jasmonoyl-isoleucine (JA-Ile) than the wild-type. DALL3 acted to suppress excess JA-Ile production after wounding, whereas dall2 dall3 double mutants strongly reduce jasmonate signalling in leaves distal to wounds. LOX6 and DALL2 function to produce OPDA and the non-bilayer-forming lipid sn-2-OPDA-MGMG in the primary vasculature. Membrane depolarizations trigger rapid depletion of these molecules. We suggest that electrical signal-dependent lipid phase changes help to initiate vascular jasmonate synthesis in wounded leaves.

Infection of groundnut ringspot virus in Plumeria pudica characterized by irregular virus distribution and intermittent expression of symptoms.

Plumeria pudica, known as bridal bouquet, exhibiting characteristic symptoms of orthotospovirus infection were found in different localities in Brazil. Symptoms were restricted to leaves of the middle and lower thirds of a few branches of each plant. Electron microscopy, molecular analyses, and complete genome sequencing identified the orthotospovirus as groundnut ringspot virus (GRSV),member of the species Orthotospovirus arachianuli. The virus was poorly transmitted mechanically to P. pudica. Reverse transcription polymerase chain reaction (RT-PCR) and reverse transcription quantitative polymerase chain reaction (RT-qPCR) analyses performed using total RNA extracted from leaf blades, primary veins, petioles, and regions of petiole insertion on branches indicated the presence of GRSV, predominantly in the symptomatic leaf blades. Symptomatic branches propagate vegetatively, often resulting in plants expressing GRSV symptoms. In contrast, vegetative propagation of the asymptomatic branches of infected plants predominantly generates plants without GRSV symptoms. The resistance of P. pudica plants to GRSV infection, restricted systemic viral movement, and expression of symptoms in infected plants suggest that this orthotospovirus does not threaten this ornamental plant.

Dragonfly-Inspired Wing Design Enabled by Machine Learning and Maxwell's Reciprocal Diagrams.

This research is taking the first steps toward applying a 2D dragonfly wing skeleton in the design of an airplane wing using artificial intelligence. The work relates the 2D morphology of the structural network of dragonfly veins to a secondary graph that is topologically dual and geometrically perpendicular to the initial network. This secondary network is referred as the reciprocal diagram proposed by Maxwell that can represent the static equilibrium of forces in the initial graph. Surprisingly, the secondary graph shows a direct relationship between the thickness of the structural members of a dragonfly wing and their in-plane static equilibrium of forces that gives the location of the primary and secondary veins in the network. The initial and the reciprocal graph of the wing are used to train an integrated and comprehensive machine-learning model that can generate similar graphs with both primary and secondary veins for a given boundary geometry. The result shows that the proposed algorithm can generate similar vein networks for an arbitrary boundary geometry with no prior topological information or the primary veins' location. The structural performance of the dragonfly wing in nature also motivated the authors to test this research's real-world application for designing the cellular structures for the core of airplane wings as cantilever porous beams. The boundary geometry of various airplane wings is used as an input for the design proccedure. The internal structure is generated using the training model of the dragonfly veins and their reciprocal graphs. One application of this method is experimentally and numerically examined for designing the cellular core, 3D printed by fused deposition modeling, of the airfoil wing; the results suggest up to 25% improvements in the out-of-plane stiffness. The findings demonstrate that the proposed machine-learning-assisted approach can facilitate the generation of multiscale architectural patterns inspired by nature to form lightweight load-bearable elements with superior structuralproperties.

A modified primary culture method of rat pulmonary vein smooth muscle cells

BackgroundAlthough the pressure of pulmonary vein increases before pulmonary artery in pulmonary hypertension due to left heart disease (PH-LHD), only a few studies have assessed pulmonary vein smooth muscle cells (PVSMCs) because of the lack of a simple and feasible isolation method.MethodsIn this study, we introduced a simple method to obtain PVSMCs. Primary pulmonary veins were removed by puncture needle cannula guidance. Then, PVSMCs were cultured by the tissue explant method and purified by the differential adhesion method. The cells were characterized by hematoxylin-eosin (HE) staining, immunohistochemistry, western blotting, and immunofluorescence to observe the morphology and verify the expression of alpha-smooth muscle actin (α-SMA).ResultsThe HE staining results showed that the pulmonary vein media was thinner than the pulmonary artery, the intima and adventitia of the pulmonary vein were removed by this method, and the obtained cells with good activity exhibited morphological characteristics of smooth muscle cells. In addition, higher α-SMA expression was observed in the cells obtained by our isolation method than in the traditional method.ConclusionThis study established a simple and feasible method to isolate and culture PVSMCs that might facilitate the cytological experiments for PH-LHD.

Spathiphyllum frailescanense (Araceae), a new species from Sierra Madre of Chiapas, Mexico

During fieldwork conducted between 2020 and 2022 in the Sierra Madre of Chiapas, we discovered a previously undescribed species of Spathiphyllum. It is morphologically similar to S. matudae, but differs in having shorter petioles, lanceolate or elliptic-lanceolate blades, sometimes subovate, fewer pairs of primary veins per side, stipitate spadix and its pistils constricted between the ovary and the style. Here, we describe and illustrate S. frailescanense, a new species of Araceae from the Sierra Madre de Chiapas, Mexico.

Morphological , Anatomical and Chemical Studies of Salvia Rosmarinus Spenn. Growing in Al- Marj (Libya)

Salvia rosmarinus Spenn (synonym: Rosmarinus officinalis L.) is economically and medically important and grows naturally in Al-Marj (Libya). Macro, micro morphological and chemical characteristics were studied. Leaf venation, leaf anatomy and chemical compounds of essential oils were carried out according to traditional methods. The objective of the present study is to provide detailed description of the characteristics of this species. Morphological charactersistics of leaves, calyx, corolla, stamens are useful for sectional and specific delimitations in Salvia. The leaf architecture characters of primary, secondary, tertiary and quaternary veins are good diagnostic markers for the identification and classification of species. Anatomical characters such as glandular and non- glandular trichomes , mesophyll structure, presence of hypodermis and structure of vascular bundles have been found to have taxonomic value. Cineol (32.38%) is main component of essential oil, followed by Camphor, β-pinene, borneol, Caryophyllene, α-terpineol and α-pinene. Chemical data in essential oils carried taxonomic value of Salvia species.

Ricca’s factors as mobile proteinaceous effectors of electrical signaling

Leaf-feeding insects trigger high-amplitude, defense-inducing electrical signals called slow wave potentials (SWPs). These signals are thought to be triggered by the long-distance transport of low molecular mass elicitors termed Ricca's factors. We sought mediators of leaf-to-leaf electrical signaling in Arabidopsis thaliana and identified them as β-THIOGLUCOSIDE GLUCOHYDROLASE 1 and 2 (TGG1 and TGG2). SWP propagation from insect feeding sites was strongly attenuated in tgg1 tgg2 mutants and wound-response cytosolic Ca2+ increases were reduced in these plants. Recombinant TGG1 fed into the xylem elicited wild-type-like membrane depolarization and Ca2+ transients. Moreover, TGGs catalyze the deglucosidation of glucosinolates. Metabolite profiling revealed rapid wound-induced breakdown of aliphatic glucosinolates in primary veins. Using invivo chemical trapping, we found evidence for roles of short-lived aglycone intermediates generated by glucosinolate hydrolysis in SWP membrane depolarization. Our findings reveal a mechanism whereby organ-to-organ protein transport plays a major role in electrical signaling.

Perforator of the popliteal fossa as a reflux point in primary and recurrent varicose veins

Perforator of the popliteal fossa as a reflux point in primary and recurrent varicose veins