Primary varices pathogenesis. The appealing unitary model

• Published in: Chirurgia (Bucharest, Romania : 1990) Vol. 105; no. 5; pp. 631 - 636
• Main Authors: Calotă, F, Vasile, I, Mogoantă, S, Meşină, C, Paşalega, M, Rusu, L, Moraru, E, Stoicea, M C, Mirea, C, Camen, D
• Format: Journal Article
• Language: English
• Published: Romania 01.09.2010
• Subjects: Disease Progression; Hemodynamics; Humans; Severity of Illness Index; Varicose Veins - classification; Varicose Veins - diagnosis; Varicose Veins - etiology; Varicose Veins - physiopathology; Varicose Veins - therapy
• ISSN: 1221-9118

Primary varices pathogenesis is still unclear about the trigger event and the disease progression. Throughout time, a lot of hypotheses were created, each with a certain degree of veracity, to explain the aforementioned dilemmas. Present day investigation technologies allowed the undeniable progress in deciphering venous mechanics and biochemistry. Objectifying venous hemodynamic and valvular-parietal changes, their dynamic progression as well, lead to important clarifications in primary varicose disease physiopathogenesis. The importance of establishing a complete, unitary pathogenic model implies the practical possibility of immediately applying the right therapy addressing the pathogenic mechanism of this disease (i.e. correcting the "pressure escape" gateway) correlated with the progression stage (reflux degree) and the type of primary varices (gravitational, non-gravitational, or "suspended" varices). Initially, our study produces a critical evaluation of the classic pathogenic hypotheses and, later on, based on our long time experience in this field, it presents a complete and unitary, evolutive and pathogenic model in primary varices. The proposed model details a pathogenesis and a progression far more nuanced in primary varices, based on solid evidence, having obvious therapeutic implications and predictable results.