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Article
February 1, 1929

THE IMPAIRMENT OF CIRCULATION IN THE VARICOSE EXTREMITY

Arch Surg. 1929;18(2):671-686. doi:10.1001/archsurg.1929.04420030065004
Abstract

While varicose veins may occur in various parts of the body, the superficial venous system of the lower extremity is of greatest clinical interest. The anatomy of these veins points out forcibly the unfavorable situation of the great and small saphenous veins between the skin and the superficial fascia. The number and distribution of valves,1 their origin and development,2 the anastomoses between the great and small saphenous vein and the communications between the superficial and deep venous system3 have all been extensively and repeatedly studied. Large variations in the course of the saphenous veins and the frequent appearance of accessory veins at unexpected sites would indicate an adaptation of man to changes of posture. In this respect, the varying course of the small saphenous vein, which is the main superficial venous channel in lower animals, has been thoroughly studied and emphasized by Kosinski.3

The histology of the veins has been

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