scholarly journals Segmental Hypoplasia of the Great Saphenous Vein and Varicose Disease

2004 ◽  
Vol 28 (3) ◽  
pp. 257-261 ◽  
Author(s):  
A Caggiati ◽  
E Mendoza
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Disease

scholarly journals ULTRASTRUCTURAL CHANGES IN THE WALL OF THE GREAT SAPHENOUS VEIN AT THE VARICOSE DISEASE OF VEINS OF LOWER LIMBS DEPENDING ON AGE AND ILLNESS DURATION

2018 ◽  
Vol 26 (2) ◽  
pp. 26-31
Author(s):  
I. A. Chekmareva ◽  
Kh. A. Abduvosidov ◽  
O. V. Paklina ◽  
E. A. Makeeva ◽  
L. L. Kolesnikov
Keyword(s):  
Endothelial Dysfunction ◽  
Young People ◽  
Connective Tissue ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Lower Limbs ◽  
Ultrastructural Changes ◽  
Middle Aged ◽  
Aged People ◽  
Varicose Disease

The aim of the study was features of ultrastructural changes in cellular elements and connective tissue carcass of the great saphenous vein (GSV) at varicose disease in depending on the duration of the disease in persons of different ages. An examination by light microscopy of 133 fragments of BPV, excised during phlebectomy in 19 patients, and an electron microscopic examination of 532 preparations were performed. Depending on the age of the patients, four age groups was distinguished: 18-44 years old (young people); 45-59 years (middle-aged people); 60-74 years old (the elderly), 75-90 years old (persons of senile age). In the wall of the GSV of young people with a small duration of the disease, there were poorly expressed pathomorphological changes characterized by moderately expressed endothelial dysfunction and minor hypertrophy of smooth muscle cells (SMC) of the middle shell. In the group of middle-aged people, in addition to age-related changes in the structure of the wall of varicose dilated GSV, pathological changes are noted that are characteristic of the long course of the disease with the development of endothelial dysfunction. The phenotypic heterogeneity of the SMC in the middle shell intensifies, and the communication links between them is altered. Disorganization of connective tissue leads to a decrease in the strength of the connective tissue vein skeleton. Hypertrophy of SMC, as a universal compensatory-adaptive response of cells, develops in response to an increase in functional load with hemodynamic disturbances in the veins of the lower limbs and to compensate for the quantitative deficiency of SMC as a result of their death. In elderly and senile age the duration of varicose disease is more than 10 years, on average - up to 25-30 years. The number of destructively altered SMC is increasing, degenerative processes and sclerotic changes are progressing. The ultrastructural analysis of biopsies showed that at the initial stage of development of varicose disease in young people with a small duration of varicose disease, morphological changes in the structure of the GSV wall are poorly expressed. With the increase in the age of the patient and the duration of the disease, changes in GSV are progressed. Involute degenerative-dystrophic changes are most pronounced in patients over 60 years of age and are an aggravating factor during varicose transformation of the GSV wall. In elderly and senile age, the compensatory possibilities of the cells decrease, the sclerotic degenerative changes in the wall of the GSV are progressed.

scholarly journals Endovenous obliteration in the combined treatment of chronic venous diseases

2020 ◽  
Vol 24 (1) ◽  
pp. 45-48
Author(s):  
M. M. Musaev ◽  
M. V. Ananyeva ◽  
A. G. Girсiashvili ◽  
A. V. Gavrilenko
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Skin Pigmentation ◽  
Combined Treatment ◽  
Modern Approach ◽  
Tumescent Anesthesia ◽  
Radiofrequency Obliteration ◽  
Venous Diseases ◽  
Varicose Disease

The modern approach to the treatment of chronic venous insufficiency and varicose veins utilizes physical techniques for endovasal obliteration. It is characterized by significantly fewer side effects and opens new possibilities for the treatment of patients with varicose disease. Purpose: To evaluate the effectiveness of radiofrequency obliteration of varicose veins and puncture laser obliteration of perforant veins in the combined treatment of patients with varicose disease (VD). Material and methods. Outcomes of treatment of 528 patients with VD in the pool of the great saphenous vein (GSV) or small saphenous vein (SSV) have been analyzed. These patients had the combined treatment, which included radiofrequency obliteration of GSV and SSV trunk and / or Giacomini vein. Of these, 335 patients had also ECHO Foam-Form sclero-obliteration of GSV and SSV inflows and perforant veins on the thigh and / or ankle. In 266 patients, their treatment was combined with miniphlebectomy of GSV and SSV inflows and perforant veins on the thigh and / or ankle; and in 55 patients – with puncture laser obliteration of perforant veins. Results. The assessment of curative outcomes have has shown that postoperative pain intensity (VAS) was 3.1 + 0.5. Transient paresthesias were seen in 14 (3.4%) cases. Local ecchymoses – in 18 (4.3%) cases. Consequences of tumescent anesthesia: local ecchymoses and hyposthesia passed after 3–5 days. Skin pigmentation was noted in 1 case and lasted up to 3 months. Thrombosis was registered in 2 cases as a parietal thrombus in the great saphenous vein at the level of the middle third of the thigh; and in 2 cases as a thrombotic clot prolapse.

Symptoms, clinical disability scores and reflux in complicated and uncomplicated primary varicose veins

2003 ◽  
Vol 18 (2) ◽  
pp. 73-77 ◽  
Author(s):  
J Saarinen ◽  
M Heikkinen ◽  
V Suominen ◽  
J Virkkunen ◽  
R Zeitlin ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Venous Insufficiency ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Clinical Classification ◽  
Disability Score ◽  
Duplex Imaging ◽  
Primary Varicose Veins ◽  
Varicose Disease

Objective: To evaluate the role of subjective symptoms, grade of disability and axial reflux in superficial veins in different clinical stages of varicose veins (VVs). Methods: A total of 172 legs with primary venous insufficiency from 126 patients were studied. The examination involved evaluation of the CEAP clinical class and clinical disability score (CDS), recording of any symptoms of varicose disease, and a hand-held Doppler (HHD) examination of the superficial veins. Colour-flow duplex imaging (CFDI) was also performed in 22% of the legs. Results: The rate of insufficiency of the great saphenous vein (GSV) was 83% in complicated legs (C4-6), and 68% in uncomplicated legs (C2-3), ( P > 0.05). There was a difference between complicated and uncomplicated legs in the insufficiency of the whole GSV [C4-6: n = 18 (39%) versus C2-3: n = 12 (12%), P < 0.005]. Sensation of pain was noted in 68% of the legs in class C1, 60% of those in class C2-3 and 81% of those in class C4-6. Sensation of oedema was recorded in 70% of the legs in class C1, 65% of those in class C2-3 and 86% of those in class C4-6, respectively. CDS classes 2-3 were significantly more frequent among complicated legs (C4-6: 54% versus C2-3 12%, P < 0.005). Conclusions: Leg symptoms are frequent throughout classes C1-6. Their clinical usefulness is therefore limited. CDS parallels well with the clinical classification. In complicated disease the whole saphenous vein is more frequently insufficient.

scholarly journals Great saphenous vein diameter at different regions and it's relation to reflux

2019 ◽  
Vol 7 (1) ◽  
pp. 10
Author(s):  
Said I. El Mallah ◽  
Yahia M. Al Khateep ◽  
Kareem H. Kamel
Keyword(s):  
Knee Joint ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Treatment Modalities ◽  
Group V ◽  
Group Iii ◽  
Below The Knee ◽  
Group I ◽  
Varicose Disease ◽  
Proximal Thigh

Background: Great saphenous vein (GSV) incompetence is involved in the majority of cases of varicose disease. Standard pre-interventional assessment is required to decide the treatment modalities. GSV diameter measured at sapheno-femoral junction, proximal thigh, distal thigh, knee, proximal leg, distal leg. Analysis done to find at which diameter size the reflux expected to occur.Methods: The study involved 100 limbs from outpatient vascular clinic. GSV diameter measurement was done at the sapheno-femoral junction, at the proximal thigh, at the distal thigh, below the knee, mid leg in correlation to the reflux.Results: SFJ reflux (group I) was observed at 7.16±2.30 mm, proximal thigh (group II) at 6.60±1.89 mm, distal thigh (group III a) at 6.12±1.63 mm, knee (group III b) at 5.78±1.60 mm, proximal leg (group IV) at 4.6±1.24 mm, and mid leg (group V) at 3.59±1.16 mm.Conclusions: Measurement at six sites revealed higher sensitivity and specificity to predict reflux, GSV diameter correlates with reflux, sites to predict reflux not only at SFJ and proximal thigh but GSV measurement at knee joint can predict reflux. Measurement of GSV at knee joint can predict reflux if more than 5.5 mm.

scholarly journals Evaluation of the presence and localization of P2 receptors in human blood vessels

2015 ◽  
Vol 96 (3) ◽  
pp. 368-376
Author(s):  
B A Ziganshin ◽  
D A Slavin ◽  
D F Khaziakhmetov ◽  
A P Ziganshina ◽  
L E Slavin ◽  
...  
Keyword(s):  
Smooth Muscle ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Immunohistochemical Analysis ◽  
Cystic Artery ◽  
Receptor Subtypes ◽  
P2 Receptor ◽  
Muscular Layer ◽  
Endothelial Layer ◽  
Varicose Disease

Aim. To study the presence and localization of the P2X and P2Y receptor subtypes in the human cystic artery and great saphenous vein (with and without varicose disease).Methods. Segments of the human blood vessels were stained using a standard two-step immunohistochemical analysis using primary and secondary antibodies. In the experiments primary antibodies to the following receptors were used: Р2Х1, Р2Х2, Р2Х3, Р2Х4, Р2Y1, Р2Y2, Р2Y4. In order to determine the presence of a receptor in a vessel sample a comparison was made between staining of the experimental and the control samples, which were not treated with primary antibodies.Results. Immunohistochemical analysis of the cystic artery showed the presence of Р2Х1, Р2Х3, Р2Y1, Р2Y2 receptors. All receptor subtypes were found to be located in the muscular layer of the artery, whereas the P2Y1 receptor was also expressed on the surface of the endothelial cells. In the great saphenous vein without varicose disease Р2Х1, Р2Х2 и Р2Y1 receptor subtypes were identified, all of which were found to be located on the smooth muscle cells of the vein. Similarly to the cystic artery, the Р2Y1 receptor was also found within the endothelial layer of the vein. At the same time, only Р2Х2 и Р2Y1 receptor subtypes were expressed in the muscular layer of the great saphenous vein affected by varicose disease. No P2 receptor subtypes were identified on the endothelial layer of the varicose-diseased vein.Conclusion. Different P2 receptor subtypes were found to be present in the smooth muscle and endothelial layers of the human cystic artery and great saphenous vein. The identified differences in the receptor subtypes between samples of great saphenous veins with and without varicose disease are, most likely, explained by the restructuring of the receptor apparatus as a result of varicose disease progression.

scholarly journals Dynamics of clinical characteristics and biomarkers of coagulation hemostasis within the application of the endovenous electric welding for varicose disease of the lower extremities

2019 ◽  
Vol 23 (2) ◽  
pp. 243-247
Author(s):  
S. I. Savoliuk ◽  
A. Yu. Glagolieva
Keyword(s):  
Platelet Count ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Lower Extremities ◽  
The Body ◽  
Venous Stasis ◽  
Electric Welding ◽  
Varicose Disease ◽  
Prospective Longitudinal ◽  
D Dimer

The article presents the results of prospective longitudinal study, in which the dynamics of fibrinogen, D-dimer, the platelet count levels have been evaluated in comparison with clinical changes within the application of endovenous electric welding (EVEW) in automatic mode for varicose vein treatment in 33 patients. The statistical analysis of the results was performed using SPSS Inc. software. (Chicago, IL, USA, version 22.0). One week after the operation, a complete obliteration of the great saphenous vein, as determined by ultrasonography, was observed in 26 patients (78.8%), while in 7 patients, a remaining lumen was registered (21.2%); after 12 months, the complete occlusion of the trunk without signs of recanalization or varicose disease progression was determined in 100% patients. After 1 week, the symptoms of venous stasis (edema, heaviness in the lower extremities) disappeared in 32 (97%) patients; in one case, the edema remained until the day 12. The great saphenous vein occlusion after EVEW application was accompanied by changes in coagulation homeostasis, which reflected in the dynamics of D-dimer, fibrinogen and the platelet count. One week after surgery, these parameters were higher in patients with incomplete occlusion, indicating the maintenance of coagulation activity of the body as a component of treatment aimed to complete the process of insufficient vein obliteration. Gradual decrease in platelet count as one of the markers of cell apoptosis indicates a continuous decrease in the activity of venous wall inflammation. No blood flow impairment in the deep veins of the lower extremities or thrombophlebitic changes in the trunk of the great saphenous vein or its tributaries have been detected.

Invasive therapeutic options in truncal varicosity of the great saphenous vein

VASA ◽  
2006 ◽  
Vol 35 (3) ◽  
pp. 157-166 ◽  
Author(s):  
Hach-Wunderle ◽  
Hach
Keyword(s):  
Minimally Invasive ◽  
Saphenous Vein ◽  
Venous Insufficiency ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Venous Pressure ◽  
Stage Iii ◽  
High Ligation ◽  
Surgical Trauma ◽  
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 ◽  
2008 ◽  
Vol 37 (06) ◽  
pp. 297-300
Author(s):  
N. König ◽  
H. J. Stark ◽  
P.-M. Baier
Keyword(s):  
Differential Diagnosis ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Case Reports ◽  
Malignant Tumours ◽  
Nerve Sheath Tumour ◽  
Below The Knee ◽  
Nerve Sheath ◽  
Unfavourable Prognosis ◽  
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.

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