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Microvenous Valvular Mapping in the Human Lower Extremity. Valvular Density Alone Cannot Account for Sites of Chronic Venous Stasis and Ulceration.

Published online by Cambridge University Press:  02 July 2020

S. Aharinejad ,
S. Nedwed ,
W. Michlits ,
R.M. Dunn ,
F. Nourani ,
D. Abraham ,
A. Vernadakis  and
S.C. Marks Jr.
S. Aharinejad
Affiliation:
, Lab. for Cardiovascular Research, First Dept. of Anatomy, U.Vienna, A-1090, Vienna, Austria
S. Nedwed
Affiliation:
, Lab. for Cardiovascular Research, First Dept. of Anatomy, U.Vienna, A-1090, Vienna, Austria
W. Michlits
Affiliation:
, Lab. for Cardiovascular Research, First Dept. of Anatomy, U.Vienna, A-1090, Vienna, Austria
R.M. Dunn
Affiliation:
Division of Plastic Surgery, UMMC, Worcester, MA, 01655, USA
F. Nourani
Affiliation:
, Lab. for Cardiovascular Research, First Dept. of Anatomy, U.Vienna, A-1090, Vienna, Austria
D. Abraham
Affiliation:
, Lab. for Cardiovascular Research, First Dept. of Anatomy, U.Vienna, A-1090, Vienna, Austria
A. Vernadakis
Affiliation:
Division of Plastic Surgery, UMMC, Worcester, MA, 01655, USA
S.C. Marks Jr.
Affiliation:
Dept. of Cell Biology, UMMC, Worcester, MA, 01655, USA
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Extract

In the leg venous valves isolate the blood into short columns and thus relieve the vessel wall from the gravitational force of blood columns that would otherwise be several feet in length. Class 6 chronic venous insufficiency is associated with abnormal venous hemodynamics and associated tissue-related abnormalities termed lipodermatosclerosis, accompanied by ulceration. Ingenious surgical techniques have focused on correction of the abnormal hemodynamics by repair, reconstruction, or transplantation of venous valves to the deep venous system of the lower extremity with varying success rates. We have applied free scapular fasciocutaneous flaps to successfully reconstruct recalcitrant grade 6 venous insufficiency ulcers in the lower extremity. We have noticed such ulcers frequently in medial malleolar, lateral malleolar or dorsum pedis but never in the region of the gastrocnemius or peroneus muscles. This fact prompted us to examine the microvenous valvular anatomy in segments of human leg.

Type
Applications and Advances in Vascular Corrosion Casting in Microvascular Research
Information
Microscopy and Microanalysis , Volume 6 , Issue S2: Proceedings: Microscopy & Microanalysis 2000, Microscopy Society of America 58th Annual Meeting, Microbeam Analysis Society 34th Annual Meeting, Microscopical Society of Canada/Societe de Microscopie de Canada 27th Annual Meeting, Philadelphia, Pennsylvania August 13-17, 2000 , August 2000 , pp. 556 - 557
Copyright
Copyright © Microscopy Society of America

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