Ultrasound imaging of lower limbs nerves: implications to venous interventions

Abstract

In the last two decades number of venous interventions for primary varicose veins increased significantly. One of the most frequent complications of venous procedures is damage of peripheral nerves of lower limbs. Both conventional open surgery and less invasive thermal ablative methods may lead to nerves injury. There are some typical areas where nerves are at most risk when different venous interventions are performed. One of the possible tools to prevent nerve damage is preoperative ultrasound scanning. With the use of modern ultrasound devices it is not very difficult to visualize peripheral nerves. It is also possible to find nerves, lying close to targeted veins at the time of venous procedure and thus to adjust technical steps to nerves and veins anatomy.

The article aims to present authors' experience in sonography of nerves that may be injured during different venous procedures. The classic anatomy and sonographic anatomy of most nerves of interest are presented with images.

Key words

lower limb nerves - damage - ultrasound imaging - varicose veins - venous intervention

Schlüsselwörter

Nerven der unteren Extremitäten - Schädigung - Ultraschallbildgebung - Varikose - venöse Intervention

Publication History

Article published online:
08 December 2020

• Literatur

• 1 Rabe E, Pannier-Fischer F, Bromen K. et al. Bonner Venenstudie der Deutschen Gesellschaft für Phlebologie. Epidemiologische Untersuchung zur Frage der Häufigkeit und Ausprägung von chronischen Venenkrankheiten in der städtischen und ländlichen Wohnbevölkerung. Phlebologie 2003; 32: 1-14
• 2 Zolotukhin IA, Seliverstov EI, Shevtsov YN. et al Prevalence and Risk Factors for Chronic Venous Disease in the General Russian Population. Eur J Vasc Endovasc Surg 2017; 54 (06) 752-758 . doi:10.1016/j.ejvs.2017.08.033
• 3 Hirsch T. Varicose Vein Therapy and Nerve Lesions. Vasa 2017; 46 (02) 96-100 . doi:10.1024/0301-1526/a000588. Epub 2016 Dec 16
• 4 Morrison C, Dalsing MC. Signs and symptoms of saphenous nerve injury after greater saphenous vein stripping: Prevalence, severity and relevance for modern practice. J Vasc Surg 2003; 38: 886-890
• 5 Aremu MA, Mahendran B, Butcher W. et al. Prospective randomised controlled trial: Conventional versus powered phlebectomy. J Vasc Surg 2004; 39: 88-94
• 6 Holme JB, Skajaa K, Holme K. Incidence of lesions of the saphenous nerve after partial or complete stripping of the long saphenous vein. Acta Chir Scand 1990; 156: 145-148
• 7 Atkin GK, Round T, Vattipally VR. et al. Common peroneal nerve injury as a complication of short saphenous vein surgery. Phlebology 2007; 22 (01) 3-7
• 8 Dermody M, O’Donnel T, Balk E. Complications of endovenous ablation in randomized controlled trials. J Vasc Surg: Vein and Lymph 2013; 1 (04) 427-36
• 9 Anwar MA, Lane TR, Davies AH. et al. Complications of radiofrequency ablation of varicose veins. Phlebology 2012; 27 (Suppl. 01) 34-39
• 10 Dexter D, Kabnick L, Berland T. et al. Complications of endovenous lasers. Phlebology 2012; 27 (Suppl. 01) 40-45
• 11 Lawrence P. “Better” (sometimes) in vascular disease management. J Vasc Surg 2016; 63 (01) 260-269 . doi:10.1016/j.jvs.2015.10.022
• 12 Ricci S, Moro L, Antonelli Incalzi R. Ultrasound Imaging of the Sural Nerve: Ultrasound Anatomy and Rationale for Investigation. Eur J Vasc Endovasc Surg 2010; 39 (05) 636-641 . doi:10.1016/j.ejvs.2009.11.024