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A Journal on Phlebology
Acta Phlebologica 2001 April;2(1):1-6
language: English, Italian
Both subterminal greater saphenous vein valve and wall are not affected by lymphomonocyte infiltration in primary chronic venous insufficiency. A preliminary report
Botta G. 1, Belcastro M. 1, Mancini S. 1, Ferrari F. 2, Cintorino M. 2, Mancini S. 1
1 Università degli Studi - Siena, Centro di Ricerca, Terapia e Riabilitazione Flebolinfologica, Istituto di Chirurgia Generale e Specialità Chirurgiche;
2 Istituto di Anatomia ed Istologia Patologica
BACKGROUND: Venous valve destruction has been often considered one of the main mechanisms involved in the pathogenesis of lower limb chronic superficial venous system insufficiency. Inflammatory processes, along with transendothelial migration of activated leukocytes on the valve leaflet base, have been hypothesized as one of the possible causes of tissue damage and consequent valve retraction. Current studies in provide contradictory data concerning this possible cause of valve damage.
METHODS: Between January 1999 and February 2000, at the Center of Phlebolymphology Research, Therapy and Rehabilitation of the University of Siena, during surgical procedures for chronic venous insufficiency we have taken by non-traumatic surgical exeresis 31 sections of proximal internal saphenous vein. The specimens comprising the valve leaflet implant area have been set in 10% formaldehyde solution and sent to the Institute of Pathology and Histology to research for lymphomonocyte infiltrates in the valve leaflets and/or the valve leaflet implant area tissue.
RESULTS: 18 specimens out of the 31 have been excluded from the study due to the lack of valve structures. Histology responses of the thirteen specimens have been subdivided into three groups on the basis of lymphomonocyte infiltration:
— absence of lymphomonocyte elements, n=11, 84,6%;
— rare, isolated non significant lymphomonocyte elements, n=2, 15,4%;
— significant lymphomonocyte infiltration, n=0, 0%.
CONCLUSIONS: On the basis of our current data, we confirm that the amount of lymphomonocyte infiltration and the subsequent inflammation of the valve and valve tissue implant area does not seem at all significant nor frequent, so as to justify the hypothesis of a correlation between post-inflammatory valve leaflet retraction and chronic vein insufficiency due to valve reflux.