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New Indian Journal of Surgery

Volume  9, Issue 1, Jan-Feb 2018, Pages 27-31
 

Original Article

A Prospective Study of Incidence of Bifid Great Saphenous Vein

Kshitij Manerikara, Iqbal Alib, Pratham Modyc, Mirat Dholakiaa

aSenior Resident bProfessor cSurgery Resident, Department of Surgery, Dr. DY Patil Medical College Hospital and Research Centre, Sant Tukaram Nagar, Pimpri, Pune, Maharashtra, 411018, India.

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DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9118.5

Abstract

Introduction: The GSV can be identified by the tibiogastrocnemius angle sign between the distal third of thigh and proximal third of calf on duplex venous ultrasound. Incidence of duplication of GSV varies between 1 and 52 percent. Present study was undertaken to note the incidence of bifid GSV.

Materials and Methods: A prospective nonrandomized study of hundred patients was carried out between June 2016 and May 2017. Preoperative venous mapping of GSV was carried out. The occurrence of duplicated GSV was recorded. Bifid GSVs were followed up to their origin. Diameter of GSV < 2.5 mm was considered as narrow calibre GSV and diameter >5 mm was considered as dilated one. All patients underwent trendelenburg’s operation. Descriptive statistics were calculated. P < 0.05 was considered as statistically significant.

Results: The mean age of patients was 47. The number of tributaries varied from 2 to 6 at SFJ. Venous duplex ultrasound preoperatively showed that there was bifid GSV in 4%, narrow calibre GSV in 4% and dilated GSV in 6% patients. Intraoperatively, bifid GSV was present in 6% patients. Two patients had narrow calibre GSV. Intraoperatively we found that in 3 patients GSV’s were draining into the SFJ as a common trunk and in remaining patients it was draining in to the junction individually. Maximum frequency of GSV duplication was seen in the thigh region (66.7%) patients followed by in the ankle region in (33.3%) patients.

Conclusion: True incidence of bifid GSV is difficult to estimate. It is surely less than the available literature suggests. Our study showed no statistical difference in incidence of bifid GSV on preoperative duplex ultrasound and its subsequent confirmation as intraoperative finding; hence, duplex ultrasound marking of GSV preoperatively is advisable. One should emphasise that the success rate of surgery is relevant to the anatomical variation of GSV and knowledge of same will decrease the recurrence rates of varicose veins.

 

 


Keywords : Femoral Vein; Saphenous Vein; Phlebography; Incidence; Varicose Veins; Duplex; Lower Extremity; Recurrence. 
Corresponding Author : Iqbal Ali, Professor, Department of Surgery, Dr D Y Patil Medical College Hospital and Research Centre, Sant Tukaram Nagar, Pimpri, Pune, Maharashtra 411018, India.