PMC8354335_01
(A), (B) Right lower limb VV; (C) engorged neck veins; (D) pulsatile flow in the GSV at the SFJ; (E) pulsatile flow in the femoral vein.
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When we saw her at our clinic, the first striking feature we noted was the abnormal distribution pattern of VV (Figures 1A, B). The neck veins were dilated (Figure 1C). A venous duplex scan of her right lower limb revealed arterial type pulsatile flow in the proximal GSV (Figure 1D) and the common femoral vein (Figure 1E).
PMC8354335_02
(A) Abnormal right lower limb VV; (B) arterial type flow at the SFJ; and (C) superficial veins; (D) CT angiogram depicting the AVM.
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On examination, there were large varicosities over the right thigh and leg with an abnormal distribution pattern (Figure 2A). A duplex scan of the right lower limb showed an arterial type of flow pattern in the superficial varices (Figure 2B, C) and the femoral vein. AVM involving the right thigh and the leg. (Figure 2D) The main feeding vessels were from the superficial femoral artery and the popliteal artery. A clinical picture was suggestive of Parkes-Weber syndrome (PWS).