1. Valves of the Venous System of the Lower Extremities, Pelvis & Abdomen
S. Lakhanpal MD
President & CEO
Center for Vein Restoration

2. Histology of a Venous Valve
The Venous Valves:
Bicuspid infoldings of the intima covered by endothelium on both sides with an intervening connective tissue skeleton.
At the origin of these valves veins may be focally distended forming small sinusoid dilatations in response to the hemodynamic consequences of focally reversed flow.

3. Valves Assisting One Way Flow
The Venous Valves:
Bicuspid inholdings of the intima covered by endothelium on both sides with an intervening connective tissue skeleton
At the origin of these valves veins may be focally distended forming small sinusoid dilatations in response to the hemodynamic consequences of focally reversed flow.

4. Vein Valve Mechanisms

5. Location and No. of Valves
Deep Veins of the Lower Extremity
Frequency increases from proximal to distal.
Deep veins of the foot, posterior and anterior tibial, peroneal are profusely valved at every 2 cm interval.
The popliteal vein and the distal femoral vein usually have 1-2 valves.
The more proximal part of the femoral vein up to its junction with the profunda vein -three or more, with one just distal to the junction.
In the CFV there is usually just one valve.
EIV and CFV proximal to the SFJ 1 or none.
Common Iliac and IVC
Usually no valves.
Perforating Veins
Valves direct blood flow from superficial to deep.

6. Valves in the Deep Veins
The number of deep venous valves increases from cranial to caudal.
Unlike the infrainguinal veins, the iliac veins rarely contain valves.
There are on average five deep venous valves between the inguinal ligament and popliteal fossa, although the number varies from two to nine.
The external iliac and common femoral vein above the saphenofemoral junction usually have one valve at most; the femoral vein above the adductor canal has three or more valves; the distal femoral and popliteal veins have one or two valves; and the tibial/peroneal veins have numerous valves spaced at 12-cm intervals.
Relatively constant stations include a valve in the femoral vein just distal to its confluence with the deep femoral vein and in the popliteal vein just distal to the adductor canal. Competence of the popliteal valves is particularly important to calf muscle pump function.

7. Ovarian Vein - Anatomy Provide drainage to the
Parametrium, cervix, mesosalpinx, pampiniform plexus.
Forms a rich anastomotic venous plexus with the:
Paraovarian, uterine, vesical, rectal and vulvar plexus.
2-3 trunks form a single ovarian vein at L4.
Left ovarian vein drains into the LRV
Right Ovarian vein drains into the IVC
10% ROV’s drain into the RRV
The ovarian veins have an average diam. of 5mm.
Valves are present mainly in the distal third
Absence of valves in 15% on the left side and 6% on the right side.
Ahlberg NE, Bartley O, Chidekel N. Right and left gonadal veins. An
anatomical and statistical study. Acta Radiol Diagn (Stockh)
1966;4:

8. Ovarian Vein - Anatomy

9. Location and No. of Valves
Superficial venous system of the lower extremity
More constant valves at the termination of a trunk other valves st transparentare delicate almost transparent.
GSV
Usually at least 6 valves (14-25), with a constant valve between 2-3 cms from the SFJ(85%)
The frequency of valves is greater below the knee
SSV
More numerous (median 7-10) Range Highest valve is close to the termination of the SSV
SSV GSV connections
Directs from SSV to GSV

10. Thank You