Anatomical variability of superficial veins of the lower limb in human fetuses

Abstract

Background. Modern minimally invasive methods have radically changed the clinical landscape of varicose vein surgery and shortened recovery time after surgery. All these changes became possible thanks to the constant deepening of knowledge about the topographical and anatomical features of the great and small saphenous veins in different periods of human ontogenesis. Objective is to find out the topographical and anatomical relationships of the great and small saphenous veins in human fetuses of 4-8 months. Methods. The research was carried out on preparations of the lower extremities of 26 human fetuses of 81.0-310.0 mm parietal-coccygeal length (PCL) without external signs of anatomical deviations or anomalies in the development of bone, fascial-muscular, and vascular-nervous structures of the lower extremities using macromicroscopic preparation, injection of vessels and morphometry. Results. In human fetuses of 4-8 months, the great saphenous vein passes directly under the fascia of the lower leg, partly in the subcutaneous tissue, since the formation of the latter is continuing at this stage of ontogenesis. In the majority of the examined fetuses, a classical version of the topography of the great and small saphenous veins of the right and left lower limbs was observed. In some cases, variability in the number of inflows of superficial veins, additional saphenous veins, and various anastomoses between additional and great and small saphenous veins was revealed. The most interesting, from our point of view, were the anatomical variants of the superficial veins of the lower limb in fetuses of 180.0, 195.0, 220.0, and 265.0 mm PCL. Conclusions. In the fetal stage of human ontogenesis, the anatomical variability of the superficial veins of the lower limbs was established, which is characterized by the variability of the shape, topography, and bilateral asymmetry of the inflows of the great and small saphenous veins and the formation of venous anastomoses. In one case, a left anterior additional saphenous vein was detected, and in two fetuses, a left posterior additional saphenous vein was detected. The coincidence of the topography of the subcutaneous veins of the right and left lower extremities was noted in 87.5% of the fetuses. Significant gender differences in the topography of the large and small subcutaneous veins in human fetuses were not found. The revealed variants of the fetal topography of the great and small saphenous veins are important for the correct interpretation of phlebographic research data and the individual strategy of the most rational method of surgical intervention.