Engorged superficial veins
were visible on the neck and upper chest suggestive of mild SVC obstruction.
Perforating veins cross the muscle fascia and link the deep veins beneath the fascia to the superficial veins
. Recent global trends for treating lower extremity chronic venous disease is helped in no small part by using endovenous laser ablation.
Clinical examination revealed alopecic, shiny skin affecting almost the entire body (Figure 1), with the exception of hands, face, feet, perigenital area, furrows along the course of the superficial veins
, the "groove sign" at the upper extremities, impaired mobility of ankles, knees and elbows.
Perforator veins, that connect the deep and superficial venous networks, play an important role in the initiation and progression of varicose vein dilatation, as the presence of reflux in the perforator veins leads to increased venous pressure in the superficial venous network, with secondary varicose dilation of superficial veins
Varicose veins are enlarged and twisted superficial veins
that often appear blue or purple.
As per the recommendations of kidney disease outcome quality initiative (KDOQI), autologous radiocephalic or brachiocephalic AVFs are primary method of choice in HD patients2, but vascular access becomes challenging in the patients with failed radio-cephalic (RC) or brachiocephalic (BC) fistulae and with smaller caliber superficial veins
. Due to which, as a secondary option the basilic vein transposition (BVT) is recommended in these patients3.
First, the flap was elevated with a lateral incision over the skin island; sling sutures were used for retraction to avoid damage to the exposed superficial veins
Perforators are located between the deep and the superficial veins
[great saphenous vein (GSV), small saphenous vein (SSV), anterior or posterior accessory GSV or VVs].
Variations of the superficial veins
of the head and neck.
In more severe cases, varicose veins can result in dermatitis, an itchy rash that can cause ulcers and bleeding if the skin is scratched; in some instances, phlebitis, a blood clot in the superficial veins
near the skin's surface, can occur.
The few valves present in these perforants are turned so that blood can only run from the deep to the superficial veins
, thus helping with thermoregulation and pressure absorption.