The role of circumflex femoral veins in the saphenofemoral junction incompetence: a case report.

A 31 year-old female patient, an opera singer, came for a consultation, mainly for aesthetic problems of the lower limbs. An asymptomatic bilateral P-point pelvic shunt was demonstrated by the EchoDoppler, while no nutcracker syndrome was detected. The examination demonstrated a medial circumflex femoral vein (MCFV), going into the common femoral vein and then into the great saphenous vein (GSV). The Valsalva manoeuvre showed the GSV terminal valve incompetence. A dilated MCFV vein at the level of the saphenofemoral junction was the source of the reflux through the GSV, while the external iliac vein was competent. GSV reflux with Valsalva was present only in the lying position. Flow in the MCFV was directed toward the CFV during and after the Valsalva. The examination shows clearly that a GSV reflux can sometimes occur in absence of iliac reflux. Circumflex femoral veins (medial and lateral) are anatomical variations, but common findings during ordinary EchoColourDoppler investigations of the venous system of the lower limbs.

A severe neurological event during a local anaesthesia phlebectomy.

A 58 year old female patient underwent an intervention of phlebectomy below the knee. The patient gradually developed a severe neurological event and the Glasgow Coma Score decreased dramatically. After two and a half hours from onset, general conditions gradually improved and recovered completely. Lidocaine neurotoxicity was excluded. A right side motor deficit strongly suggests a transient ischaemic attack. As to invasivity, phlebectomy can be compared with liquid and foam sclerotherapy so that the simple question arises of also comparing their adverse effects. We have the strong conviction that this case may only be a co-incidental association.

[The 1st national multicenter study of the CHIVA (Conservative Therapy and Hemodynamics in Venous Insufficiency in Outpatient Departments) method of treatment of varices. One-year follow-up]. / I multicentrica Nazionale sulla metodica CHIVA nel trattamento delle varici. Follow-up ad un anno.

The authors present clinical and instrumental results of N. 543 operations executed by CHIVA system. These cases are the result of trial performed in seven SIOC (Italian Society of CHIVA Operators) centers executed from November '87 to July '89. Functional and aesthetic results had been very good on over 85% of all cases; superficial thrombosis were verified on 10% of all cases but almost completely asymptomatic. The aa. propose to start a deeper trial on 500 patients choose by rigorous criteria of inclusion.