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Abstract:
The author who is the director of the Anatomical Institute of the Faculty of Medicine at Jassy precisely describes the course, the variant forms, the collaterals and especially the communicating and perforating branches of the external saphenous vein and indicates the practical significance of these details which were obtained as a result of the dissection of 4500 cadavers which was performed either by himself or under his direction. In 7% of the cases a double external saphenous vein was found (a superficial branch running subcutaneously and another situated in a fold of the aponeurotic tibial sheath). In 6% of cases an unfolding of the external saphenous was found with separate penetration in the aponeurotic sheath and with separate outlets (one in the vein of Giacomini and the other in the popliteal vein). The author gives an account of the total perforating and communicating network and of the deep venous system which contributes to the phenomenon of venostasic. These perforating and communicating branches could be demonstrated by microdissection made possible by an original injection technique used on fresh cadavers (Dr Ciomu Naum Nicolae). Apart from this, the author indicates and demonstrates that varices proper are not due to valvular insufficiency but to "bad material" as he calls it. It is precisely this "bad material" which leads to venectasia and consequently to inefficiency of the valves. Dissection of large excised varices has revealed valves which are intact within the dilated venous lumen and walls which are extremely thin. Equally, the author considers the pathology of the external saphenous vein (septic phlebitis or trauma) and outlines their treatment.