An anatomical study of femoral vein valves near the saphenofemoral junction

BackgroundThe relevance of venous valves in varicose veins is still discussed controversially as, among others, the veins' wall weakness is accused to be the initial trigger of varicose veins. Thorough knowledge of their positions and frequencies will support understanding the pathogenesis of varices. Contrary to the incidences of valves in the femoral vein, no sufficient data about the positions of valves, particularly in respect to the saphenofemoral junction, are available; specifically in conjunction with the fact that terminal and preterminal valves in the great saphenous vein are missing in 10% of cases.MethodsThe exact positions and distances of valves in both the common femoral and the femoral vein close to the saphenofemoral junction were studied macroscopically in 32 cadavers with a total of 63 veins. Measurements were performed from the saphenofemoral junction as reference point above and below.ResultsValves in the common femoral vein exist in 71% of all cases with a mean distance of 3.8 cm proximally to the saphenofemoral junction. Distal valves are present in 87% of all cases with a mean distance of 5.0 cm. In more than a half, a second distal valve can be found at about 9 cm, which has not been described yet. Females have a significantly shorter mean distance of this second distal valve on the right side.ConclusionIncorporating the study results on terminal and preterminal valves in the great saphenous vein, we have a well defined overview about the positions of the valves and frequencies in the coherent area of confluence of the superficial inguinal veins. More than ever, further studies, mainly about the real functions of valves, are necessary.

Clinical RelevanceThe high prevalence of venous diseases, recently confirmed by the Bonn Vein Study 2003 and the varying treatment options, demonstrate the relevance of fundamental studies. Though venous valves should not be the trigger for varicose veins, it is generally agreed that their incompetence is “a central feature in the natural history of primary and post-thrombotic venous diseases” and knowledge of their positions and frequencies will support understanding the pathogenesis of varices.