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A total of 657 incompetent GSVs of 553 patients were treated by means of the EVLA procedure; 104 patients had bilateral VSM insufficiencies.
At the end of 24 months, treatment to 611 GSVs was evaluated as successful and to 46 GSVs as unsuccessful.
It has been generally accepted that VAMP2 is the v-SNARE present on GSVs, although other v-SNAREs, such as VAMP3, VAMP7, and VAMP8, have also been suggested to be present on GLUT4 vesicles and implicated in vesicle exocytosis [14, 107, 108].
In this process, multiple trafficking steps of GLUT4 are potentially regulated by insulin signaling, including GSV release and trafficking , vesicle tethering/docking [10-12], and ultimately fusion [13-15].
Rac1 pathway involves rearrangement of actin-filaments and cortical actin branching, mediated by actin-related proteins 2/3 (ARP2/3) complexes , which provides a path along which GSVs are transported, and is crucial for retention and fusion of GSV beneath the plasma membrane .
Insulin signaling damage also plays a role in insulin resistance of skeletal muscle, by impairing GLUT4 storage vesicles (GSV) translocation.
INTRODUCTION: The Great saphenous vein (GSV) also known as long, internal or greater saphenous vein is the longest vein in our body.
DISCUSSION: A rare anatomical variation found in this case that is duplication of GSV. Which has incidence of 1%?
A superficial dissection was done in the superficial fascia of the lower limb to dissect the GSV from its beginning in front of medial malleolus at ankle to its termination into the femoral vein in the upper thigh region at the saphenous opening.
The GSV began as the medial end of dorsal venous arch, is joined by medial marginal vein in front of the medial malleolus of the ankle.
Followup included any symptoms, residual and recurrent varicose veins determined by physical examination, as well as the closure and recanalisation of the GSV using ultrasound.
Although different methods have different results, EVLT is at least as effective as surgery in treating varicosity of the GSV.8 The primary failure and recurrence in EVLT was not significantly different from that of surgery.9 EVLT is safe, and although more energy is used, this has not translated into higher complication rates.3,10 Based on the experience of others, we explored and improved the treatment.
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