ORIGINAL ARTICLES   

International Angiology 2002 December;21(4):337-43

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: English

Changes of elastic and collagen fibers in varicose veins

Wali M. A. ¹, Eid R. A. ²

¹ Department of Surgery, College of Medicine and Medical Sciences, King Khalid University, Abha, Saudi Arabia 2 Department of Pathology, College of Medicine and Medical Sciences, King Khalid University, Abha, Saudi Arabia

Background. The resis­tance to ­stretch and the elas­tic­ity of the vein wall ­depend on the col­la­gen and elas­tic ­fibers, respec­tive­ly. Contradicting evi­dence ­exists, how­ev­er, on the con­nec­tive tis­sue con­cen­tra­tion in var­i­cose veins.
Methods. A pros­pec­tive, com­par­a­tive study was con­duct­ed at Asir Central Hospital and the College of Medicine in Abha, Saudi Arabia. Twenty-three vein spec­i­mens col­lect­ed from both the prox­i­mal thigh long saph­e­nous vein (LSV) and the dis­tal calf blow­outs in 10 pri­mary var­i­cose vein ­patients and from the nor­mal, prox­i­mal thigh LSV in 3 young vas­cu­lar trau­ma ­patients were exam­ined. Paraffin sec­tions ­stained with hem­a­tox­y­lin and eosin, Verhoeff von Gieson (VVG) and Masson’s Trichrome ­stains were exam­ined under the light micro­scope. Ultra thin sec­tions were exam­ined under the trans­mis­sion elec­tron micro­scope (TEM).
Results. Compared with the nor­mal con­trol LSV, var­i­cose vein sec­tions ­showed ­increased diam­e­ter of the lumen and hyper­tro­phy of the wall, main­ly of the inti­ma, due to ­increased ­amounts of col­la­gen ­fibers. This ­marked ­fibrous infil­tra­tion dis­rupt­ed the nor­mal pal­i­sade arrange­ment of the inti­mal and the reg­u­lar sheet-like arrange­ment of the medi­al ­smooth mus­cle cells. Collagen ­fibers also lost their nor­mal pat­tern and ­showed abnor­mal forms. Elastic ­fibers lost their reg­u­lar lam­i­nar arrange­ment and ­formed ­clumps or scat­tered frag­ments.
Conclusions. Varicose veins ­showed ­increased col­la­gen­o­sis and dis­tor­tion of the elas­tic ­fibers. The pres­ence of abnor­mal col­la­gen to elas­tin ratio and the loss of the reg­u­lar col­la­gen/elas­tic lat­tice of the vein wall may play a major role in the path­o­gen­e­sis of var­i­cose veins.