Abstract
Objective
Bilateral large variant veins were encountered in the lower extremity. It was aimed to identify the structural characteristics of this rare case and then, regarding the structural features, to overview its formation process and denomination.
Material and method
During the routine dissection of a 93-year-old male cadaver, bilateral large variant veins were found at the thigh. Valves of the veins were examined and evaluated together with the vascular wall histology.
Results
The variant vein was loosely attached to the sciatic nerve by fibrous tissue and had anastomoses with the popliteal vein in the popliteal fossa on each side. The popliteal veins were hypoplastic on both sides. The right variant vein was passing through the fibers of the adductor magnus muscle 56.2 mm above the adductor hiatus, which corresponds to the third perforating branch of deep femoral vein. The left one was turning to the front over the adductor magnus muscle, at the lower border of quadratus femoris muscle. The left variant vein was corresponding to the descending branch of the medial circumflex femoral vein. Both variant veins had one incomplete and three well-developed valves.
Conclusion
In accordance with the findings, the variant vein was concluded to be an embryonic remnant, rather than an acquired one subsequent to any obstruction of the femoral vein. Regarding their connection with the popliteal vein but not with the internal iliac vein, both variant veins were denominated as “lower type persistent sciatic vein”. Such a variation would be important with respect to the risk of complication during popliteal sciatic nerve blockade.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Caggiati A (2008) Embryology and distribution of lower limb venous valves in humans. Medicographia 30:100–105
Cherry KJ, Gloviczki P, Stanson AW (1996) Persistent sciatic vein: diagnosis and treatment of a rare condition. J Vasc Surg 23:490–497
Eberlová L, Tolar J, Mikulás J, Valenta J, Kocová J, Hirmerová J, Fiala P (2011) Variability of the deep femoral venous system. Cas Lek Cesk 150(6):344–346
Futamata H, Kawate T, Sakamoto H, Kitami Y, Takeda S (2008) Large-caliber persistent sciatic artery with aneurysm. Anat Sci Int 83(4):301–306
Golan JF, Garrett WV, Smith BL, Talkington CM, Thompson JE (1986) Persistent sciatic artery and vein: an unusual case. J Vasc Surg 3(1):162–165
Goss K (2008) Lower extremity regional anesthesia with the low sciatic nerve block. Clin Podiatr Med Surg 25:431–441
Jung SC, Lee W, Chung JW, Jae HJ, Park EA, Jin KN, Shin CI, Park JH (2009) Unusual causes of varicose veins in the lower extremities: CT venographic and Doppler US findings. Radiographics 29(2):525–536
Kachlik D, Pechacek V, Baca V, Musil V (2012) The deep venous system of the lower extremity—new nomenclature. Phlebology 27:48–58
le Noble F, Moyon D, Pardanaud L, Yuan L, Djonov V, Matthijsen R, Bréant C, Fleury V, Eichmann A (2004) Flow regulates arterial-venous differentiation in the chick embryo yolk sac. Development 131(2):361–375
Moore HM, Gohel M, Davies AH (2011) Number and location of venous valves within the popliteal and femoral veins: a review of the literature. J Anat 219:439–443
Mukouyama YS, Shin D, Britsch S, Taniguchi M, Anderson DJ (2002) Sensory nerves determine the pattern of arterial differentiation and blood vessel branching in the skin. Cell 109(6):693–705
Natsis K, Totlis T, Paraskevas G, Papathanasiou E, Sofidis G, Noussios G (2008) Axial transformation of the profunda femoris vein: formation, relations and course in a cadaveric specimen. Folia Morphol 67:304–306
Park EA, Chung JW, Lee W, Yin YH, Ha J, Kim SJ, Park JH (2011) Three-dimensional evaluation of the anatomic variations of the femoral vein and popliteal vein in relation to the accompanying artery by using CT venography. Korean J Radiol 12(3):327–340
Parry DJ, Aldoori MI, Hammond RJ, Kessel DO, Weston M, Scott DJ (2002) Persistent sciatic vessels, varicose veins, and lower limb hypertrophy: an unusual case or discrete clinical syndrome. J Vasc Surg 36(2):396–400
Peirce RM, Funaki B (2002) Direct MR venography of persistent sciatic vein in a patient with Klippel–Trenaunay–Weber syndrome. AJR Am J Roentgenol 178(2):513–514
Raju S, Fountain T, Neglén P, Devidas M (1998) Axial transformation of the profunda femoris vein. J Vasc Surg 27:651–659
Renaudin JM, Fiscel C, Mercier F, Denost F, Turpault I, Falson OB, Finet M (1999) Smooth muscle differentiation in human vein wall at valvular level: comparison with nonvalvular wall and correlation with venous function. Angiology 50(1):21–30
Servelle M (1985) Klippel and Trénaunay’s syndrome. 768 operated cases. Ann Surg 201(3):365–373
Standring S (ed) (2005) Gray’s anatomy, 39th edn. Churchill Livingstone, New York, pp 1452–1453
Uhl JF, Gillot C, Chahim M (2010) Anatomical variations of the femoral vein. J Vasc Surg 52(3):714–719
Uhl JF, Gillot C (2007) Embryology and three-dimensional anatomy of the superficial venous system of the lower limbs. Phlebology 22(5):194–206
Wang HU, Chen ZF, Anderson DJ (1998) Molecular distinction and angiogenic interaction between embryonic arteries and veins revealed by ephrin-B2 and its receptor Eph-B4. Cell 93(5):741–753
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Koç, T., Gilan, İ.Y., Külekçi, G.D. et al. Bilateral persistent sciatic vein: report of a case with developmental, histological and clinical aspects. Surg Radiol Anat 36, 189–194 (2014). https://doi.org/10.1007/s00276-013-1146-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00276-013-1146-9