Types of outlet of the major saphenous vein tributaries in patients with chronic vein insufficiency of the lower limbs

Chronic vein insufficiency (CVI) is a disease which, when it develops, leads to varicose veins of the lower limbs. As approximately 25% to 50% of people suffer from it, it should be recognised as a public disease. The treatment of chronic vein insufficiency is based on a surgical approach. The aim of the operation is to remove (strip) the insufficient major saphenous vein (MSV), the main cause of the disease. The major saphenous vein drains into the femoral vein and forms the sapheno-femoral junction, which is located in the hiatus saphenous within the femoral triangle. We conducted 94 varicose vein operations by the Babcock method on patients suffering from chronic vein insufficiency. This surgical treatment was performed in "Therapy", a private clinic for peripheral vessel disease. We operated on 52 left lower limbs and 42 right lower limbs. The patients were qualified for the operation procedure after physical examination and Doppler ultrasonography imaging. We identified 5 types of major saphenous vein tributary drainage. The most common was Type I, in which there were 3 tributaries draining directly into the major saphenous vein. This type consisted of 45 cases (47.87%). We distinguished here 3 modifications. In Type II, however, there were 4 direct tributaries that drained into the major saphenous vein in 23 cases (24.46%). In this group of patients also 3 modifications were distinguished. Type III occurred in 14 cases (14.89%). We identified here 2 direct tributaries that drained into the saphenous vein and divided this type into 2 modifications. Type IV occurred in 8 cases (8.51%). Here we found 5 or 6 direct tributaries depending on the number of the external pudendal veins. Type V turned out to be very rare, occurring in only 4 cases (4.25%). Among all the types mentioned a thin tributary 1–2 mm wide was found in 10 cases (10.63%). This ran from under the fascia cribrosa into the saphenofemoral junction in the hiatus saphenous. This may be one of the causes of the recurrences of chronic vein insufficiency. There is also the possibility that a tributary will be overlooked or ignored during the operation, particularly when Type IV appears with 5 or 6 direct collaterals

Arterial supply of the olfactory trigone and the anterior perforated substance in macrosmatic and microsmatic animals

An investigation was conducted into the differences between macrosmatic and microsmatic animals of arterial supply in the area of the olfactory trigone and the anterior perforated substance. A brain of domestic cat was taken as an example of a macrosmatic animal and a brain of baboon as an example of a microsmatic animal. The cerebral blood vessels of the cadavers of 30 cats and 11 baboons were filled with latex and, after fixation in acid alcohol by means of microscopic operation, the cortical and deep branches of the anterior and middle cerebral arteries were dissected. We discovered that there were differences between these two groups of animals in the places of arising of deep branches and in their course. In the cat the deep branches running through the area of the olfactory trigone arose from the beginning part of the middle cerebral artery in numbers 5–10 and entered the brain in the olfactory tubercle. In the baboon the deep branches arose from two sources: the middle cerebral artery and the anterior cerebral artery. The branches of the middle cerebral artery went through the anterior perforated substance, forming two groups of branches: lateral and medial

The Epidemiological, Morphological, and Clinical Aspects of the Aberrant Right Subclavian Artery (Arteria Lusoria)

The most common embryologic abnormality of the aortic arch is aberrant right subclavian artery (ARSA), known clinically as arteria lusoria (AL). This vessel travels to the right arm, crossing the middle line of the body and usually passing behind the esophagus. If the artery compresses the esophagus, it may produce a condition called dysphagia lusoria. Another commonly reported symptoms related to compression of adjacent structures by arteria lusoria were dyspnea, retrosternal pain, cough, and weight loss greater than 10 kg over a 6-month period. The chapter includes information describing demographic, clinical, and morphological characteristics of presence of arteria lusoria such as gender distribution, frequency in population, frequency of the most commonly reported symptoms related to compression of adjacent structures, coexistence with the most common vascular anomalies and diagnostic procedures. The presence of arteria lusoria together with the right nonrecurrent inferior laryngeal nerve (NRILN) is especially clinically important; during thyroid surgery, the right laryngeal nerve cannot be found at the lower pole of the thyroid, and it may be injured by the surgeon if it is not identified in the aberrant area or found lateral to the thyroid