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A Journal on Phlebology

Official Journal of the Italian College of Phlebology
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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.

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