VARIANT S OF TOPOGRAP HY OF VESSEL S OF THE TRIGONUM FEMORALE SCARPAE ZONE
1Federal State Budget Educational Institution of Higher Education «Ryazan State Medical University named after academician I.P. Pavlov», Ryazan, Russia
2State Budgetary Institution «Ryazan Regional Clinical Cardiological Dispensary», Ryazan, Russia
Access to the femur triangle is often used in vascular surgery: virtually all operations on the venous system require access to the saphenofemoral junction, and if the arterial system is affected, access to the femoral artery is necessary for a significant number of surgical interventions. Classical descriptions of topographic anatomy and operative surgery characterize the area of the Scarp triangle, or the femoral triangle, as a region with a permanent topography of the vessels: under the superficial leaf of the broad fascia, within the femoral triangle, there are large femoral vessels surrounded by the vagina – a. and v. femoralis. Topographically, the artery is lateral, the vein is medial. They lie in the recess, which forms the muscles of the bottom of the femoral triangle – m. iliopsoas (outside) and m. pectineus (inside), covered with a deep leaf of the broad fascia. The main branches of these vessels at the subfascial level are a. and v. profunda femoris, leaving at a distance of 3-5 and 6-8 cm below the inguinal ligament from the main trunks. At the episfascial level, v. femoralis has another major influx – v. saphena magna, which passes in the fatty deposits of the medial surface of the thigh. In the femoral triangle, the vein penetrates the wide fascia of the thigh through hiatus saphenus, flows into the femoral vein from the medial surface, forming a saphenofemoral anastomosis. Inflows v. saphena magna on the thigh – v. epigastrica superficialis, vv. pudendae externae and v. circumflexa ilium superficialis – flow into it within the femoral triangle. In addition, there may be less permanent tributaries: v. saphena accessoria medialis and v. saphena accessoria lateralis. At the same time, in practice, there are variants of individual variability in the topography of the vessels in this area, which can create difficulties and lead to errors both in the course of diagnosis and in the following – when performing surgical interventions. In the article, the main variants of the topography of the femoral triangle vessels, revealed by ultrasonic duplex scanning of vessels, are presented in clinical examples.
Keywords: Trigonum femorale Scarpae, variants of vessel topography.
- Kalinin RE, Suchkov IA, Zherebyatyeva SR, Pshennikov AS. Operatsii na sosudakh: Uchebnoe posobie [Operations on vessels]. Moscow, RF: GEOTARMedia; 2015. 119 p.
- Kalinin RE, Suchkov IA, Puchkova GA, Pashchenko VM, Shanaev IN, Kamaev AA, Podyablonskaya IA . Izuchenie raboty proksimal’nogo klapana sobstvennoy bedrennoy veny i vliyanie faktorov vis a tergo i vis a fronte na ego rabotu [ А study of the femoral vein proximal valve function and the influence of vis a tergo and vis a fronte factors to it work]. Vestnik Avitsenny [Avicenna Bulletin]. 2017;19(1):21-25. Available from: http://dx.doi. org/10.25005/2074-0581-2017-19-1-21-25.
- Lubotskiy DN. Osnovy topograficheskoy anatomii [The basics of topographic anatomy]. Moscow, RF: Medgiz; 1953. 647 p.
- Ostroverkhov GE, Bomash YUM, Lubotskiy DN. Operativnaya khirurgiya i topograficheskaya anatomiya [Operative surgery and topographic anatomy]. Moscow, RF: MIA; 2005. 736 р.
- Gaibov AD, Kamolov AN, Sharipov MA, Kalmykov EL. Khirurgicheskaya taktika pri yatrogennoy travme sosudov i eyo posledstviyakh [Surgical approach for vascular iatrogenic injury and its consequences]. Annaly khirurgii. 2009;2:35-9.
- Marcucci G. A rare anomaly of the femoral vessels: complete transposition of the femoral artery and vein. Interactive Cardiovascular and Thoracic Surgery. 2010;11:838-9.
- Вandyopadhyay M, Biswas S, Roy R. Vessels in femoral triangle in a rare relationship. Singapore Medical Journal. 2010;51(1):3-5.
- Oyama LJ. Incomplete transposition of the common femoral artery and vein. Int Angiology. 2010;29(1):80-2.
Kalinin Roman Evgenyevich, Doctor of Medical Sciences, Full Professor, Head of the Department of Cardiovascular, Endovascular, Operative Surgery and Topographic Anatomy, Ryazan State Medical University named after academician I.P. Pavlov
Suchkov Igor Aleksandrovich, Doctor of Medical Sciences, Associate Professor, Professor of the Department of Cardiovascular, Endovascular, Operative Surgery and Topographic Anatomy, Ryazan State Medical University named after academician I.P. Pavlov
Puchkova Galina Anatolyevna, Medical Doctor at the Department of Vascular Surgery, Ryazan Regional Clinical Cardiological Dispensary
Pashchenko Vasiliy Mikhaylovich, Doctor of Biological Sciences, Professor of the Department of Mathematics, Physics and Medical Informatics, Ryazan State Medical University named after academician I.P. Pavlov
Shanaev Ivan Nikolaevich, Candidate of Medical Sciences, Medical Doctor at the Department of Vascular Surgery, Ryazan Regional Clinical Cardiological Dispensary
Address for correspondence:
Shanaev Ivan Nikolaevich
Candidate of Medical Sciences, Medical Doctor at the Department of Vascular Surgery, Ryazan Regional Clinical Cardiological Dispensary
390048, Russian Federation, Ryazan, str. Zubkova, house 26 building 1, apt. 399
Tel.: (+7) 920 9786234