scholarly journals Formal genesis of morphological changes of the great saphenous vein wall on the calf in various periods of human life, with the development of its ectasia and varicose transformation

2020 â—½  
Vol 8 (4) â—½  
pp. 74-86
Author(s):  
A.B. Sannikov â—½  
â—½  
E.V. Shaydakov â—½  
V.M. Emelynenko â—½  
â—½  
...  
Keyword(s):  
Saphenous Vein â—½  
Great Saphenous Vein â—½  
Morphological Changes â—½  
Human Life â—½  
Vein Wall

Disequilibrium in MMPs and the tissue inhibitor of metalloproteinases in different segments of the varicose great saphenous vein wall

2019 â—½  
Vol 38 (3) â—½  
Author(s):  
Xiaoxuan Hu â—½  
Fuxing Hu â—½  
Yongbo Xu â—½  
Jinyuan Tang â—½  
Haibo Chu â—½  
...  
Keyword(s):  
Saphenous Vein â—½  
Great Saphenous Vein â—½  
Tissue Inhibitor Of Metalloproteinases â—½  
Tissue Inhibitor â—½  
Vein Wall

Histopathological changes and expression of adhesion molecules and laminin in varicose veins

VASA â—½  
2005 â—½  
Vol 34 (3) â—½  
pp. 170-175 â—½  
Author(s):  
Aunapuu â—½  
Arend
Keyword(s):  
Smooth Muscle â—½  
Adhesion Molecules â—½  
Adhesion Molecule â—½  
Saphenous Vein â—½  
Varicose Veins â—½  
Morphological Changes â—½  
Thrombus Formation â—½  
Intercellular Adhesion Molecule â—½  
Vein Wall â—½  
Group I

Background: Although varicose disease is a common pathology, etiologic factors predisposing to dilatation, elongation and tortuosity of the saphenous vein are not yet well understood. The aim of our study was to investigate morphological changes, laminin and adhesion molecules expression in the great saphenous vein. Patients and methods: Material obtained from 26 patients was analyzed using light microscopy, immunohistology and electron microscopy. Patients were divided into two age groups (group I, aged between 26 and 35 years and group II, 36–45 years). Results: In most patients veins were stretched out with highly varying wall thickness. The vein wall three-layered structure composed of intima, media and adventitia was changed in 78% of the cases. In most specimens endothelium was either damaged or missing. In such areas possible thrombus formation sites were observed characterized by erythrocyte accumulation. In media and adventitia smooth muscle cells were destroyed or showed altered morphology, the amount of connective tissue was increased together with irregular organization of collagen fibers and disruption of the elastic network around smooth muscle cell bundles. Laminin, intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) expression was increased in varicose veins wall, especially in the second group of patients (p<0.05). In addition, ICAM-1 and VCAM-1 expression was more pronounced in the wall of varicose veins of female than male patients (p < 0.05). Conclusion: We conclude that morphological alterations in varicose veins become more pronounced with advancing age, and laminin, ICAM-1 and VCAM-1 expression is related to the severity of damage and age of the patient.

Neovascularization in Recurrence of the Varicose Great Saphenous Vein following Transection

1987 â—½  
Vol 2 (2) â—½  
pp. 81-91 â—½  
Author(s):  
G.M. Glass
Keyword(s):  
Smooth Muscle â—½  
Saphenous Vein â—½  
Great Saphenous Vein â—½  
Varicose Veins â—½  
Elastic Tissue â—½  
Local Analgesia â—½  
Vascular Changes â—½  
Vein Wall â—½  
Surgical Exploration â—½  
Haemodynamic Changes

Recurrence of varicose veins after surgical treatment is widely attributed to morphological and haemodynamic changes in pre-existing collateral veins. Transection of the great saphenous vein in the thigh under local analgesia was used to promote healing of varicose ulceration. When healing was complete, saphenofemoral ligation combined with stripping or multiple ligation was performed. At the same time the vascular changes at the site of transection were investigated in 10 patients by phlebography, surgical exploration and examination of the excised vessels by radiographic and histological methods. The results showed that the continuity of the vein was restored by growth of new vessels in the surrounding tissues and vein wall. Some vessels increased in size, developing smooth muscle and elastic tissue in their walls, while the majority underwent regression. It was concluded that the theory of recurrence through pre-existing veins requires revision.

scholarly journals Study of the Influence of Homocysteine and Vitamin D Metabolism on the Development of Destructive Vascular Wall Processes

2020 â—½  
pp. 22-27
Author(s):  
O. S. Nikonenko â—½  
A. O. Nikonenko â—½  
K. O. Chmul â—½  
V. V. Osaulenko
Keyword(s):  
Vitamin D â—½  
Saphenous Vein â—½  
Great Saphenous Vein â—½  
Morphological Changes â—½  
Artery Bypass â—½  
Hypovitaminosis D â—½  
Vascular Wall â—½  
Coagulation System â—½  
Morphological Examination â—½  
Morphological Studies

To date, it has been established that in the progression of cardiovascular (CV) disorders, an increase in the level of homocysteine (HC) and hypovitaminosis D play an important role. According to the latest recommendations, the modern clinician should consider risk factors not as a diagnostic sign, but as a prognostic, contributing factor, which to some extent can lead to destructive changes in the vascular wall. The aim. To study the morphological changes of the vascular wall depending on the degree of hyperhomocysteinemia and hypovitaminosis D. Materials and methods. We analyzed data from 54 patients who, in addition to determining the level of HC and vitamin D, underwent morphological studies of fragments of the great saphenous vein and aorta. Samples were obtained during coronary artery bypass grafting. Depending on the degree of hyperhomocysteinemia and the level of vitamin D, the patients were divided into 3 groups. Results. Morphological examination of the great saphenous vein and aorta showed normal structure of the vascular wall in patients with normal levels of HC and vitamin D (78.5% and 71.4%, respectively). Patients from the groups 2 and 3 with hyperhomocysteinemia had more pronounced changes in the venous wall, regardless of the level of vitamin D. These data suggest a probable association of HC levels with the changes in the vascular wall. It was also noted that the patients of group 3 had more pronounced inflammatory infiltration of the vascular wall. Conclusions. Hyperhomocysteinemia and hypovitaminosis D are independent predictors of CV disorders and have a detrimental effect on the vascular wall and blood coagulation system, creating conditions for the progression of atherosclerosis. The higher is the level of HC, the more pronounced are morphological changes in the vascular wall of the vein, leading to hypertrophy of all layers, regardless of the level of vitamin D.

scholarly journals Adventitial Progenitor Cells of Human Great Saphenous Vein Enhance the Resolution of Venous Thrombosis via Neovascularization

2021 â—½  
Vol 2021 â—½  
pp. 1-15
Author(s):  
Siying Ling â—½  
Zhen Ma â—½  
Yong Teng â—½  
Xuemei Jiang â—½  
Junning Cheng â—½  
...  
Keyword(s):  
Endothelial Cells â—½  
Endothelial Cell â—½  
Venous Thrombosis â—½  
Progenitor Cells â—½  
Nude Mice â—½  
Saphenous Vein â—½  
Great Saphenous Vein â—½  
Vena Cava â—½  
Tube Formation â—½  
Vein Wall

Background. Vascular adventitia contains progenitor cells and is shown to participate in vascular remolding. Progenitor cells are recruited into the venous thrombi in mice to promote neovascularization. We hypothesized that the adventitial progenitor cells of human great saphenous vein (HGSV-AdPC) enhance the resolution of venous thrombosis via neovascularization. Methods. Human great saphenous vein (HGSV) was harvested from the patients with great saphenous vein varicose and sectioned for immunohistochemistry, or minced for progenitor cell primary culture, or placed in sodium dodecyl sulfate solution for decellularization. Human venous thrombi were collected from patients with great saphenous vein varicose and superficial thrombophlebitis. Infrarenal abdominal aorta of New Zealand white rabbits was replaced with interposing decellularized vessel, and the patency of the grafts was confirmed by ultrasonic examination. Animal venous thrombi in the left infrarenal vena cava of mice were produced with Prolene suture ligation and ophthalmic force clipping of this portion. After HGSVs were digested by collagenase, the CD34+CD117+ HGSV-AdPC were isolated on FACS system, labelled with CM-Dil, and transplanted into the adventitia of infrarenal vena cava of nude mice. The percentage of thrombus organization area to the thrombus area was calculated as the organization rate. The thrombus cell, endothelial cells, and macrophages in the thrombi were counted in sections. Cell smears and frozen sections of human saphenous veins and venous thrombi were labeled with Sca1, CD34, CD117, Flk1, CD31, and F4/80 antibodies. The CD34+CD117+ HGSV-AdPC were cultured in endothelial growth medium with vascular endothelial growth factor (VEGF) to induce endothelial cell differentiation and analyzed with real time-PCR, Western blotting, and tube formation assays. Results. Immunohistochemical staining showed that the CD34+CD117+ cells were located within the adventitia of HGSVs, and many CD34+ and CD117+ cells have emerged in the human venous thrombi. The number of progenitor cells within the marginal area of 7 days mice thrombi was shown to be Sca1+ ≈21%, CD34+ ≈12%, CD117+ ≈9%, and Flk1+ ≈5%. Many CD34+adventitial progenitor cells have migrated into the decellularized vessels. FACS showed that the number of CD34+CD117+ HGSV-AdPC in primary cultured cells as 1.2 ± 0.07 % . After CD34+CD117+HGSV-AdPC were transplanted into the adventitia of nude mice vena cava with venous thrombi, the organization rate, nucleate cell count, endothelial cells, and macrophage cells of thrombi were shown to be significantly increased. The transplanted CD34+CD117+ HGSV-AdPC at the adventitia have crossed the vein wall, entered the venous thrombi, and differentiated into endothelial cells. The CD34+CD117+ HGSV-AdPC in the culture medium in the presence of VEGF-promoted gene and protein expression of endothelial cell markers in vitro and induced tube formation. Conclusions. HGSV-AdPC could cross the vein wall and migrate from the adventitia into the venous thrombi. Increased HGSV-AdPC in the adventitia has enhanced the resolution of venous thrombi via differentiating into endothelial cells of neovascularization.

Invasive therapeutic options in truncal varicosity of the great saphenous vein

VASA â—½  
2006 â—½  
Vol 35 (3) â—½  
pp. 157-166 â—½  
Author(s):  
Hach-Wunderle â—½  
Hach
Keyword(s):  
Minimally Invasive â—½  
Saphenous Vein â—½  
Venous Insufficiency â—½  
Great Saphenous Vein â—½  
Varicose Veins â—½  
Venous Pressure â—½  
Stage Iii â—½  
High Ligation â—½  
Surgical Trauma â—½  
Disease Stages

It is known from current pathophysiology that disease stages I and II of truncal varicosity of the great saphenous vein do not cause changes in venous pressure on dynamic phlebodynamometry. This is possibly also the case for mild cases of the disease in stage III. In pronounced cases of stage III and all cases of stage IV, however, venous hypertension occurs which triggers the symptoms of secondary deep venous insufficiency and all the complications of chronic venous insufficiency. From these facts the therapeutic consequence is inferred that in stages I and II and perhaps also in very mild cases of stage III disease, it is enough "merely" to remove varicose veins without expecting there to be any other serious complications in the patient’s further life caused by the varicosity. Recurrence rates are not included in this analysis. In marked cases of disease stages III and IV of the great saphenous vein, however, secondary deep venous insufficiency is to be expected sooner or later. The classical operation with saphenofemoral high ligation ("crossectomy") and stripping strictly adheres to the recognized pathophysiologic principles. It also takes into account in the greatest detail aspects of minimally invasive surgery and esthetics. In the past few years, developments have been advanced to further minimize surgical trauma and to replace the stripping maneuver using occlusion of the trunk vein which is left in place. Obliteration of the vessel is subsequently performed via transmission of energy through an inserted catheter. This includes the techniques of radiofrequency ablation and endovenous laser treatment. High ligation is not performed as a matter of principle. In a similar way, sclerotherapy using microfoam is minimally invasive in character. All these procedures may be indicated for disease stages I and II, and with reservations also in mild forms of stage III disease. Perhaps high ligation previously constituted overtreatment in some cases. Targeted studies are still needed to prove whether secondary deep venous insufficiency can be avoided in advanced stages of varicose vein disease without high ligation and thus without exclusion of the whole recirculation circuit.

Malignant tumours as a rare cause of recurrent thrombophlebitis of the great saphenous vein

Phlebologie â—½  
2008 â—½  
Vol 37 (06) â—½  
pp. 297-300
Author(s):  
N. König â—½  
H. J. Stark â—½  
P.-M. Baier
Keyword(s):  
Differential Diagnosis â—½  
Saphenous Vein â—½  
Great Saphenous Vein â—½  
Case Reports â—½  
Malignant Tumours â—½  
Nerve Sheath Tumour â—½  
Below The Knee â—½  
Nerve Sheath â—½  
Unfavourable Prognosis â—½  
Peripheral Nerve Sheath Tumour

SummaryWe present two case reports concerning patients who had to undergone surgical treatment according tp the diagnosis of thrombophlebitis with insufficiency of the greater saphenous vein and putative encapsulated haematoma in the lower left leg area. During the operation we found tumours with urgent suspicion of malignancy. The histological examination revealed the diagnosis of mesenchymal chondrosarcoma and malignant peripheral nerve sheath tumour which are extremely malignant, but very rare neoplasmas with unfavourable prognosis. Conclusion: Since both types of tumours are often located below the knee, phlebotomists and vascular surgeons should take them into account as differential diagnosis.

Short stripping of the incompetent great saphenous vein by InvisiGrip® vein stripper

Phlebologie â—½  
2010 â—½  
Vol 39 (02) â—½  
pp. 77-81 â—½  
Author(s):  
A. G. Krasznai â—½  
E. C. M. Bollen â—½  
J. C. van der Kley â—½  
R. J. Th. J. Welten â—½  
G. M. J. M. Welten
Keyword(s):  
Success Rate â—½  
Saphenous Vein â—½  
Great Saphenous Vein â—½  
Femoral Nerve â—½  
Preoperative Selection â—½  
Superficial Wound â—½  
Good Cosmetic â—½  
Surgical Device â—½  
Femoral Nerve Injury â—½  
Selection Of

SummaryOur aim is to describe the results of a new short stripping technique for the treatment of the incompetent great saphenous vein (GSV) using a new developed surgical device. Patients, methods: 397 patients (498 legs) were treated with the InvisiGrip® Vein Stripper, which removes the GSV through a single groin incision, endovascular cutting and antegrade stripping by inversion. We reported the surgical success rate and postprocedural complications. Results: The mean age was 51 years, 74% were women. The success rate for removal of the GSV was 95%. The 23 failures were half patient related, half device related. In 82% of the strippings, one or two attempts were needed to successfully remove the GSV, which was done by invagination in 80%. Age, gender, BMI ≥30 kg/m2 and male GSV diameter were not associated with the number of attempts. Superficial wound infection, haematoma and temporary saphenous and femoral nerve injury occurred in 6 (1.6%), 0, 3 (0.8%) and 7 (1.9%) patients, respectively. Conclusion: The InvisiGrip® is highly successful for the removal of the GSV using short inverting stripping. Furthermore, it is simple, safe, associated with good cosmetic results and no preoperative selection of patients is necessary.

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