Varicose veins due to reflux in a tortuous sartorius muscle vein

In daily phlebology practice, duplex ultrasound may sometimes reveal unusual pathways of reflux. A 46-year-old woman presented with heaviness and pain at the medial side of the left thigh after exercise. A tortuous intramuscular course of a large refluxing vein was seen in the sartorius muscle in connection with a femoral vein perforator cranially and the below-knee great saphenous vein distally. Magnetic resonance imaging confirmed these findings. Treatment consisted of a combination of foam sclerotherapy, radiofrequency ablation, and phlebectomies.

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