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INTERNATIONAL ANGIOLOGY

A Journal on Angiology


Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2002 March;21(1):1-8

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: English

Role of the endothelium and blood stasis in the appearance of varicose veins

Michiels C., Bouaziz N., Remacle J.

From the Laboratoire de Biochimie et Biologie cellulaire, University of Namur, Namur, Belgium


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Today, chron­ic ­venous insuf­fi­cien­cy ­affects mil­lions of peo­ple but the inves­ti­ga­tion of veins and of ­venous dis­eas­es is still very poor. Additionally, the mech­a­nism of the occur­rence of var­i­cose veins is not under­stood. Blood sta­sis is often asso­ciat­ed with these path­o­log­i­cal sit­u­a­tions and we pro­pose that result­ing ischem­ic con­di­tions can trig­ger the endo­the­li­um to ­release inflam­ma­to­ry medi­a­tors and ­growth fac­tors. On one hand, the inflam­ma­to­ry medi­a­tors will ­recruit and acti­vate neu­troph­ils, which then infil­trate the ­venous wall and dam­age com­po­nents of the extra­cel­lu­lar ­matrix. On the other hand, ­growth fac­tors ­induce ­smooth mus­cle cell migra­tion, pro­life­ra­tion and de-dif­fe­ren­ti­a­tion into the syn­thet­ic phe­no­type, all togeth­er lead­ing to the for­ma­tion of neo­in­ti­ma. These pro­cess­es, being repeat­ed over time, would even­tu­al­ly lead to alter­a­tions of the ­venous wall as ­observed in var­i­cose veins. Venotropic drugs are used to treat chron­ic ­venous insuf­fi­cien­cy. They are able to ­increase ­venous tone and to ­decrease vein and cap­il­lary perme­abil­ity but they are also able to pro­tect the endo­the­lial cells ­against ische­mia. Indeed, they tar­get com­plex­es of the mit­o­chon­dri­al res­pir­a­to­ry chain and main­tain ATP pro­duc­tion dur­ing hypox­ia. Hence, the cells are resist­ant to ische­mia and do not ­release inflam­ma­to­ry medi­a­tors and ­growth fac­tors. These drugs ­should thus be able to pre­vent the alter­a­tions of the ­venous wall ­induced by blood sta­sis.

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