Der Venenstern – Anatomie und Blutfluss in den Seitenästen

In den Venen des „Venensterns“ am saphenofemoralen Übergang sind der physiologische und der pathologische Fluss fußwärts gerichtet. Die Unterscheidung kann nur an der Flussmenge und Dauer festgemacht werden. Ihre routinemäßige, gezielte Untersuchung zur Diagnostik des venösen Refluxes und insbesondere vor der Therapie der Varikose wird helfen, standardisierte Vorgehensweisen am Venenstern in Zukunft vergleichen zu können.

Abstract

Varicose veins are one of the most common chronic diseases in the western world. Not only the diagnosis of this pathology, but also the treatment options have been subject to constant change since the introduction of duplex sonography. Nevertheless, its causes are not really known yet, and there is still a lot of debate about recurrences after the various treatment options and their possible prevention strategies.

In defining venous incompetence, we assume a change in the healthy direction of flow from “upwards”/“towards the heart” or also “antegrade” or “orthograde” – to “footward” or “retrograde”. Due to insufficiency of the venous valves, the blood in varicose veins flows in the opposite direction – this is contemplated in the international definition of venous insufficiency.

Very often, the sapheno-femoral junction (SFJ) of the great saphenous vein (GSV) in the groin is involved in superficial venous pathology. However, this is where the so-called tributary veins (stellate arranged venous branches) drain to the GSV. Their physiological flow direction is towards the orifice of the saphenous vein into the femoral vein – thus “footwards” within the cranial tributary veins. In fact, these veins are therefore an exception. The direction of flow in this vein is the same in a physiological situation as in case its insufficiency – the difference lies in the quantity and duration of flow. This fact is reviewed in this paper. Attention to the clinical relevance is emphasised.

Schlüsselwörter

Venenstern - Krosse der V. saphena magna - saphenofemoraler Übergang - venöse Hämodynamik - Varikose - venöse Insuffizienz

Key words

venous star - saphenofemoral junction - venous hemodynamics - varicose veins - venous insufficiency

Publikationsverlauf

Artikel online veröffentlicht:
10. Februar 2023

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