Patients with primary varicose veins have few venous valves in the proximal femoral vein and great saphenous vein: A cadaveric and ultrasound examination of living subjects.

Objectives: The pathogenesis of primary varicose veins (PVVs) is multifactorial and remains incompletely understood; however, venous valve dysfunction is recognized as a key factor. Previous studies have suggested racial differences in the prevalence and distribution of venous valves in the proximal...

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Published in:Phlebology Vol. 41; no. 7; pp. 639 - 645
Main Authors: Mitsuoka, Hiroki, Yodogawa, Chihiro, Arima, Takahiro, Wanibuchi, Sora, Naito, Munekazu, Kodama, Akio
Format: pictorial research tables/charts Journal Article
Published: Sage Publications Inc. Aug2026
Online Access:View this record in EBSCOhost
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      dt: Aug2026
      vid: 41
      iid: 7
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: Patients with primary varicose veins have few venous valves in the proximal femoral vein and great saphenous vein: A cadaveric and ultrasound examination of living subjects.
      aug:
        au:
          Mitsuoka, Hiroki
          Yodogawa, Chihiro
          Arima, Takahiro
          Wanibuchi, Sora
          Naito, Munekazu
          Kodama, Akio
        affil: Department of Vascular Surgery, Aichi Medical University, Nagakute, Japan
      sug:
        subj:
          Varicose Veins Risk Factors
          Femoral Vein Ultrasonography
          Saphenous Vein Ultrasonography
          Femoral Vein Abnormalities
          Saphenous Vein Abnormalities
          Risk Assessment
          Cadaver
          Male
          Female
          Aged
          Aged, 80 and Over
          Human
          Prevalence
          Japan
          Adult
          Middle Age
          Wilcoxon Signed Rank Test
          Mann-Whitney U Test
          Descriptive Statistics
          Data Analysis Software
          Comparative Studies
          Venous Insufficiency
          Femoral Vein Anatomy and Histology
          Saphenous Vein Anatomy and Histology
          Varicose Veins Physiopathology
          Venous Pressure
          Aged: 65+ years
          Aged, 80 & over
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Objectives: The pathogenesis of primary varicose veins (PVVs) is multifactorial and remains incompletely understood; however, venous valve dysfunction is recognized as a key factor. Previous studies have suggested racial differences in the prevalence and distribution of venous valves in the proximal femoral vein; however, no data are available for the Japanese population. This study aimed to clarify the prevalence and number of venous valves in the proximal femoral vein and great saphenous vein (GSV) in Japanese individuals and determine whether patients with PVVs have fewer venous valves than healthy individuals. Methods: A cadaveric study of 59 individuals (median age, 87 years) and an ultrasound study involving 52 healthy volunteers (median age, 26 years) and 106 patients with PVVs (median age, 72 years) were conducted. Venous valves were assessed in segments A (from the confluence of the inferior epigastric vein to the saphenofemoral junction [SFJ]) and B (GSV within 4 cm distal to the SFJ). Results: In cadavers and volunteers, venous valves were identified in approximately 60% of segment A and nearly all of segment B, with no significant differences between the two groups. Conversely, patients with PVVs had significantly fewer venous valves in both segments A (right, 0.22 vs 0.54, p <.001; left, 0.31 vs 0.56, p =.005) and B (right, 1.29 vs 1.50, p =.034; left, 1.32 vs 1.52, p =.028) than volunteers. In several PVVs, only the venous sinus without valve leaflets was detectable by ultrasonography. Conclusions: Patients with PVVs had significantly fewer venous valves in the proximal femoral vein and GSV than healthy subjects, suggesting that valve deficiency, possibly including congenital factors, may contribute to PVV development. This study provides the first detailed data on venous valve distribution in Japanese individuals. More studies are needed to confirm these findings and clarify clinical implications.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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