The role of the giacomini vein in preoperative mapping of lower limb varicose veins.

Background: The Giacomini vein (GV) can transfer reflux from perineal veins, tributary veins, and perforators of the thigh to the small saphenous vein (SSV). Vascular ultrasound with Doppler (VUD) is the preferred method for detecting reflux in specific veins such as the GV.

Objective: To identify GV depth and diameter, reflux in the GV, and presence of reflux in the SSV caused by the GV.

Methods: A cross-sectional, retrospective study was conducted in women undergoing lower limb venous mapping for varicose vein surgery. The following parameters were analyzed in GVs in which reflux was detected: segmental or diffuse reflux pattern; GV diameter and depth; and reflux in the SSV caused by the GV.

Results: 340 of the 2368 women evaluated were included in the study because they had a GV, totaling 511 veins analyzed, 150 (29.4%) of which had reflux. The diameters of the 150 GVs with reflux ranged from 1.5 to 7.8 mm and their depth varied from 4 to 25 mm. Most GVs with reflux (91.3%) had a segmental reflux pattern. The majority (66%) of refluxing GVs drained reflux into the popliteal vein through the saphenopopliteal junction, while reflux was transferred to the SSV in 34 veins (22.7%), and was drained by a tributary vein in the thigh in 15 veins (11.3%).

Conclusions: Approximately one-third of the studied GVs had reflux, mostly segmental, mean caliber was 2.7 mm, and mean depth was 11 mm. Reflux in the SSV originating from the GV was detected in 22% of the evaluated veins.