FIGURE 32.2 Reflux through the vein of Giacomini from the GSV territory to the SSV (1) and from the SSV to the GSV territory (2).

deep vein above and below the junction that acts as the reservoir for flow. This is approximately the length expected in the adjacent deep veins between competent valves.

Ultrasound examination is the standard method to detect SSV reflux and advise appropriate treatment. However, it is probable that the examination bears little relation to the everyday hemodynamics during standing and walking, which are poorly understood. Current concepts hold that the primary abnormality for varicose disease commences in the saphenous veins and tributaries, with secondary functional valvular incompetence in many limbs as dilatation reaches the proximal junctions. Accordingly, it would be naive to anticipate that simple interruption at the junction would restore normal venous function. There is undoubtedly a complex interaction of antegrade and retrograde flow through the SSV and deep veins, and flow in either direction through some calf perforators in the presence of disease. This suggests that destruction of the entire diseased segment of SSV and TE is required for best results from treatment. This is not common surgical practice.

How To Deal With Rosacea and Eczema

How To Deal With Rosacea and Eczema

Rosacea and Eczema are two skin conditions that are fairly commonly found throughout the world. Each of them is characterized by different features, and can be both discomfiting as well as result in undesirable appearance features. In a nutshell, theyre problems that many would want to deal with.

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