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Rivista di Angiologia

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 2003 June;22(2):188-93


lingua: Inglese

Histopathological changes in the wall of varicose veins

Wali M. A. 1, Dewan M. 2, Eid R. A. 2

1 Department of Surgery, Asir Central Hospital and College of Medicine, King Khalid University, Abha, Saudi Arabia 2 Department of Pathology, Asir Central Hospital and College of Medicine, King Khalid University, Abha, Saudi Arabia


Aim. Vein wall dis­ten­sibil­ity is con­trolled by col­la­gen, elas­tin and ­smooth mus­cle cells. How­ev­er, con­tra­dict­ing evi­dence ­exists on the con­nec­tive tis­sue con­cen­tra­tion and ­smooth mus­cle pathol­o­gy in var­i­cose veins.
Meth­ods. To study the path­o­log­i­cal chang­es in the wall of var­i­cose veins at dif­fer­ent lev­els, we col­lect­ed a total of 49 vein spec­i­mens from 19 ­patients at Asir Cen­tral Hos­pi­tal, Abha, Saudi Ara­bia, dur­ing the peri­od from March to Octo­ber 1997. Three young trau­ma ­patients under­went ­repair of their arte­ri­al inju­ries using the thigh long saph­e­nous vein (LSV) and 16 var­i­cose vein ­patients under­went strip­ping of their LSV and avul­sion of their dis­tal calf var­i­cos­ities. In the trau­ma ­patients, spec­i­mens were col­lect­ed from the prox­i­mal thigh LSV while in the var­i­cose vein ­patients, spec­i­mens were col­lect­ed from both the groin and mid-thigh LSV and the dis­tal calf var­i­cos­ities. Spec­i­mens were ­stained with Hem­a­tox­y­lin & Eosin, ­Masson’s Tri­chrome and von Gie­son (VG) ­stains for exam­ina­tion under the light micro­scope.
­Results. Com­pared with the nor­mal LSV, all var­i­cose vein sec­tions ­showed ­marked inti­mal hyper­tro­phy due ­fibrous tis­sue infil­tra­tion, local­ized thin­ning of the mus­cle layer and loss of both the inti­mal and medi­al ­smooth mus­cle cells (SMCs). Elas­tic ­fibers were defi­cient and scat­tered with loss of the nor­mal elas­tin/col­la­gen lat­tice net­work and ­decrease in both the mus­cle/col­la­gen and elas­tin/col­la­gen ­ratios.
Con­clu­sion. In con­clu­sion, we pro­pose that dil­a­ta­tion and dis­ten­sibil­ity of the vein wall under nor­mal and ­increased ­venous pres­sure is due to defi­cien­cy in ­smooth mus­cle cells and elas­tic ­fibers and dis­pro­por­tion­ate ­increase in ­fibrous tis­sue.

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