Venous Morphology Predicts Class of Chronic Venous Insufficiency

• Published in: European journal of vascular and endovascular surgery Vol. 18; no. 4; pp. 349 - 354
• Main Authors: Jones, G.T, Solomon, C, Moaveni, A, van Rij, A.M, Thomson, I.A, Galvin, I
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.10.1999
• Subjects: Aged; Blood Flow Velocity; Cell Count; Chronic Disease; Chronic venous insufficiency; Elastic tissue; Elastic Tissue - diagnostic imaging; Elastic Tissue - pathology; Endothelium; Endothelium, Vascular - diagnostic imaging; Endothelium, Vascular - pathology; Human; Humans; Leg - blood supply; Middle Aged; Prognosis; Saphenous Vein - diagnostic imaging; Saphenous Vein - pathology; Severity of Illness Index; Ultrasonography, Doppler, Duplex; Varicose Ulcer - diagnostic imaging; Varicose Ulcer - pathology; Varicose Ulcer - physiopathology; Varicose veins; Venous Insufficiency - diagnostic imaging; Venous Insufficiency - pathology; Venous Insufficiency - physiopathology; Venous ulcers; Human; Venous ulcers; Chronic venous insufficiency; Elastic tissue; Varicose veins; Endothelium
• DOI: 10.1053/ejvs.1999.0902
• ISSN: 1078-5884

Objectives this study aimed to determine specific morphological differences in long saphenous veins from patients with various grades of chronic venous insufficiency. Design comparable veins from a control group were compared with patients with either primary varicose veins or those with associated skin changes including venous ulcers.Materials below-knee segments of saphenous vein were examined from a total of 64 patients. Methods veins were examined for elastic-tissue disruption and endothelial-cell changes and comparisons made between clinical groups. Results elastic-tissue disruption, as measured by fragmentation of the elastic lamina and the percentage of the intimal–medial boundary containing elastin, increased with increasing severity of venous disease. Moreover, endothelial cells became more densely packed, as measured by endothelial cell and endothelial-cell nuclei density, with increasing severity of disease. Other measures such as the density of multinucleated “giant” endothelial cells and the number of nuclei per “giant” cell did not correlate with venous disease, however. Conclusions this study demonstrates that several morphological characteristics of superficial saphenous veins correlate with severity of venous disease. In particular, the alterations to the structure of elastic tissue within these veins appears indicative of the progressive nature of chronic venous insufficiency.