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J Vasc Surg Venous Lymphat Disord. 2019 Jan;7(1):128-138.e7. doi: 10.1016/j.jvsv.2018.06.006. Epub 2018 Nov 15.

Systematic review and meta-analysis of the anatomic variants of the saphenofemoral junction.

Author information

1
Department of Surgery and Biomedical Sciences, University of Perugia, Perugia, Italy.
2
Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland. Electronic address: bmhenry55@gmail.com.
3
Unit of Surgery, Casa di Cura "Villa Pini", Civitanova Marche, Italy.
4
Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland.
5
Private Centro Vena, Florence, Italy.
6
Department of General Surgery, General Hospital, Tolmezzo, Udine, Italy.
7
Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy.
8
Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
9
Tift College of Education, Mercer University, Atlanta, Ga.

Abstract

BACKGROUND:

The aim of this systematic review was to provide comprehensive data on the prevalence of variations of the saphenofemoral junction (SFJ) to prevent misidentification of the SFJ or the incomplete ligation of the tributaries of the great saphenous vein.

METHODS:

A systematic review was conducted using the PubMed, Embase, and Cochrane Library databases through September 14, 2017. To be included in the meta-analysis, a study had to report prevalence data on the morphology of the SFJ or the presence of venous tributaries.

RESULTS:

A total of 16 studies (7433 legs) were included. The majority of studies were performed during varicose vein surgery (74.14%), with fewer studies by means of computed tomography venography and cadaveric dissection. The pooled prevalence estimate (PPE) for a duplication of the SFJ with a bifid junction was 9.6% (P = .001). The PPE for a duplication of the SFJ with two separate junctions was 1.7%. The PPE for ectasia of the SFJ was 2.3% in type 1, 1.2% in type 2, and 1.7% in type 3. The distribution of the PPE for the number of venous SFJ tributaries was approximately normal with a slight right skew; a higher rate was observed in the group with four venous tributaries to the SFJ.

CONCLUSIONS:

This analysis found high heterogeneity in the prevalence of SFJ anatomic variants and the number of venous SFJ tributaries. For this reason, it is highly recommended that a preoperative Doppler ultrasound assessment of the SFJ and great saphenous vein be performed.

KEYWORDS:

Great saphenous vein; Saphenofemoral junction; Varicose veins

PMID:
30448153
DOI:
10.1016/j.jvsv.2018.06.006

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