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Venous Anatomy, Development, and Variations

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Current Management of Venous Diseases

Abstract

Venous developmental anatomy and embryology are fundamental to understanding venous disorders. Embryologic signaling has now been defined to establish differentiation of the circuit into arterial and venous components. The venous system is the most varied system in the human body. Clinical impact of developmental anomalies is reviewed. The currently accepted terms of venous dysfunction, anatomy, and clinical syndromes associated with congenital vascular malformations are presented.

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Abbreviations

CT:

Computed tomography

DVT:

Deep venous thrombosis

GSV:

Great saphenous vein

IVC:

Inferior vena cava

LE:

Lower extremity

PLSVC:

Persistent left superior vena cava

PV:

Perforating veins

SMV:

Superior mesenteric vein

SSV:

Small saphenous vein

SVC:

Superior vena cava

VEGF:

Vascular endothelial growth factor

References

  1. Sadler TW. Langman’s medical embryology. 13th ed. Philadelphia: Wolters Kluwer Health; 2014.

    Google Scholar 

  2. Eichmann A, Yuan L, Moyon D, Lenoble F, Pardananaud L, Breant C. Vascular development: from precursor cells to branched arterial and venous networks. Int J Dev Biol. 2005;49(2-3):259–67.

    Article  CAS  PubMed  Google Scholar 

  3. Vogeli KM, Jin SW, Martin GR, Stainier DY. A common progenitor for haematopoietic and endothelial lineages in the zebrafish gastrula. Nature. 2006;443:337–9.

    Article  CAS  PubMed  Google Scholar 

  4. Swift MR, Weinstein BM. Arterial-venous specification during development. Circ Res. 2009;104(5):576–88.

    Article  CAS  PubMed  Google Scholar 

  5. Yancopoulos GD, Davis S, Gale NW, Rudge JS, Wiegand SJ, Holash J. Vascular-specific growth factors and blood vessel formation. Nature. 2000;407(6801):242–8.

    Article  CAS  PubMed  Google Scholar 

  6. Wang HU, Chen ZF, Anderson DJ. Molecular distinction and angiogenic interaction between embryonic arteries and veins revealed by ephrin-B2 and its receptor Eph-B4. Cell. 1998;93(5):741–53.

    Article  CAS  PubMed  Google Scholar 

  7. Nandy K, Blair CB Jr. Double superior venae cavae with completely paired azygos veins. Anat Rec. 1965;151(1):1–9.

    Article  CAS  PubMed  Google Scholar 

  8. Winter FS. Persistent left superior vena cava; survey of world literature and report of thirty additional cases. Angiology. 1954;5(2):90–132.

    Article  CAS  PubMed  Google Scholar 

  9. Povoski SP, Khabiri H. Persistent left superior vena cava: review of the literature, clinical implications, and relevance of alterations in thoracic central venous anatomy as pertaining to the general principles of central venous access device placement and venography in cancer patients. World J Surg Oncol. 2011;9:173. https://doi.org/10.1186/1477-7819-9-173.

  10. Lawler LP, Fishman EK. Thoracic venous anatomy: multidetector row CT evaluation. Radiol Clin N Am. 2003;41(3):545–60.

    Article  PubMed  Google Scholar 

  11. Mayo J, Gray R, St Louis E, Grosman H, McLoughlin M, Wise D. Anomalies of the inferior vena cava. Am J Roentgenol. 1983;140:339–45.

    Article  CAS  Google Scholar 

  12. Giordano JM, Trout HH III. Anomalies of the inferior vena cava. J Vasc Surg. 1986;3(6):924–8.

    Article  CAS  PubMed  Google Scholar 

  13. Babaian RJ, Johnson DE. Major venous anomalies complicating retroperitoneal surgery. South Med J. 1979;72(10):1254–8.

    Article  CAS  PubMed  Google Scholar 

  14. Chuang VP, Mena CE, Hoskins PA. Congenital anomalies of the left renal vein: angiographic consideration. Br J Radiol. 1974;47(556):214–8.

    Article  CAS  PubMed  Google Scholar 

  15. Nicholson CP, Gloviczki P. Embryology and development of the vascular system. In: White RA, Hollier LH, editors. Vascular surgery: basic science and clinical correlations. 2nd ed. Malden, MA: Blackwell Publishing; 2005. p. 3–18.

    Google Scholar 

  16. Meissner MH. Lower extremity venous anatomy. Semin Intervent Radiol. 2005;22(3):147–56.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Moneta GL, Nehler MR. The lower extremity venous system: anatomy and physiology of normal venous function and chronic venous insufficiency. In: Gloviczki P, Yao JS, editors. Handbook of venous disorders: guidelines of the American Venus Forum. 1st ed. London: Chapman & Hall; 1996. p. 2–26.

    Google Scholar 

  18. Dalton SR, Fillman EP, Ferringer T, Tyler W, Elston DM. Smooth muscle pattern is more reliable than the presence or absence of an internal elastic lamina in distinguishing an artery from a vein. J Cutan Pathol. 2006;33(3):216–9.

    Article  PubMed  Google Scholar 

  19. Ludbrook J. The musculovenous pumps of the human lower limb. Am Heart J. 1966;71(5):635–41.

    Article  CAS  PubMed  Google Scholar 

  20. Black CM. Anatomy and physiology of the lower-extremity deep and superficial veins. Tech Vasc Interv Radiol. 2014;17(2):68–73.

    Article  PubMed  Google Scholar 

  21. Basmajian JV. The distribution of valves in the femoral, external iliac, and common iliac veins and their relationship to varicose veins. Surg Gynecol Obstet. 1952;95(5):537–42.

    CAS  PubMed  Google Scholar 

  22. Eklöf B, Rutherford RB, Bergan JJ, Carpentier PH, Gloviczki P, Kistner RL, et al. Revision of the CEAP classification for chronic venous disorders: consensus statement. J Vasc Surg. 2004;40(6):1248–52.

    Article  PubMed  Google Scholar 

  23. Reich-Schupke S, Stücker M. Nomenclature of the veins of the lower limbs – current standards. J Dtsch Dermatol Ges. 2011;9(3):189–94.

    PubMed  Google Scholar 

  24. Ellis H. Clinical anatomy. A revision and applied anatomy for clinical students. 10th ed. Oxford: Blackwell; 2002.

    Google Scholar 

  25. Stonelake PA, Bodenham AR. The carina as a radiological landmark for central venous catheter tip position. Br J Anaesth. 2006;96(3):335–40.

    Article  CAS  PubMed  Google Scholar 

  26. Demos TC, Posniak HV, Pierce KL, Olson MC, Muscato M. Venous anomalies of the thorax. Am J Roentgenol. 2004;182(5):1139–50.

    Article  Google Scholar 

  27. Couvreur T, Ghaye B. Left superior vena cava. In: Rémy-Jardin M, Rémy J, editors. Integrated cardiothoracic imaging with MDCT from medical radiology diagnostic imaging and radiation oncology series. 1st ed. Berlin Heidelberg: Springer; 2009. p. 289–305.

    Chapter  Google Scholar 

  28. Sipila W, Kakkila J, Heikel PE, Kyllonen KE. Persistent left superior vena cava. Ann Med Intern Fenn. 1955;44(4):251–61.

    CAS  PubMed  Google Scholar 

  29. Kachlik D, Pechacek V, Musil V, Baca V. The deep venous system of the lower extremity: new nomenclature. Phlebology. 2012;27(2):48–58.

    Article  CAS  PubMed  Google Scholar 

  30. Kachlik D, Pechacek V, Baca V, Musil V. The superficial venous system of the lower extremity: new nomenclature. Phlebology. 2010;25(3):113–23.

    Article  CAS  PubMed  Google Scholar 

  31. Browse NL. Embryology and radiographic anatomy. In: Browse NL, Burnand KG, Irvine AT, Wilson NM, editors. Diseases of the veins: pathology, diagnosis and treatment. 2nd ed. New York: CRC Press; 1999. p. 23–48.

    Google Scholar 

  32. Corley GJ, Broderick BJ, Nestor SM, Breen PP, Grace PA, Quondamatteo F, et al. The anatomy and physiology of the venous foot pump. Anat Rec (Hoboken). 2010;293(3):370–8.

    Article  Google Scholar 

  33. Stolic E. Terminology, division, and systematic anatomy of the communicating veins. In: May R, Partsch H, Staubesand J, editors. Perforating veins. Munchen: Urban & Schwarzenberg; 1981. p. 19–34.

    Google Scholar 

  34. Caggiati A, Bergan JJ, Gloviczki P, Eklöf B, Allegra C, Partsch H. Nomenclature of the veins of the lower limb: extensions, refinements, and clinical application. J Vasc Surg. 2005;41(4):719–24.

    Article  PubMed  Google Scholar 

  35. Linton RR. The communicating veins of the lower leg and the operative technique for their ligation. Ann Surg. 1938;107(4):582–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Sherman RS. Varicose veins: further findings based on anatomic and surgical dissections. Ann Surg. 1949;130(2):218–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Cockett FB, Jones DEE. The ankle blow-out syndrome; a new approach to the varicose ulcer problem. Lancet. 1953;1(6749):17–23.

    Article  CAS  PubMed  Google Scholar 

  38. O’Donnell TF, Burnand KG, Clemenson G, et al. Doppler examination vs clinical and phlebographic detection of the location of incompetent perforating veins: a prospective study. Arch Surg. 1977;112(1):31–5.

    Article  PubMed  Google Scholar 

  39. Fischer R, Fullemann HJ, Alder W. A phlebologic dogma concerning the localization of the Cockett’s perforating veins [in French]. Phlebologie. 1992;45(2):207–12.

    CAS  PubMed  Google Scholar 

  40. Mózes G, Gloviczki P, Menawat SS, et al. Surgical anatomy for endoscopic subfascial division of perforating veins. J Vasc Surg. 1996;24(5):800–8.

    Article  PubMed  Google Scholar 

  41. Gloviczki P, Mózes G. Development and anatomy of the venous system. In: Gloviczki P, editor. Handbook of venous disorders. 3rd ed. London: Hodder Arnold; 2009. p. 19.

    Google Scholar 

  42. Mózes G, Gloviczki P. New discoveries in anatomy and new terminology of leg veins: clinical implications. Vasc Endovasc Surg. 2004;38(4):367–74.

    Article  Google Scholar 

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Acknowledgments

We would like to thank the following individuals for their assistance and input in preparing this chapter: Sheena Sullivan, Good Samaritan TriHealth Hospital, Cincinnati, OH; Michael Wolujewicz MD, Good Samaritan TriHealth Hospital, Cincinnati, OH; Paul J Dorio MD, Mercy Health West, Cincinnati, OH; and Angela N Fellner PhD CCRP, TriHealth Hatton Research Institute, Cincinnati, OH.

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Correspondence to Joann M. Lohr MD, FACS, RVT, CWSP .

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Lohr, J.M., Mouawad, N.J. (2018). Venous Anatomy, Development, and Variations. In: Chaar, C. (eds) Current Management of Venous Diseases . Springer, Cham. https://doi.org/10.1007/978-3-319-65226-9_1

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  • DOI: https://doi.org/10.1007/978-3-319-65226-9_1

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