Changes in Metalloproteinase (MMP-1, MMP-2) Expression in the Proximal Region of the Varicose Saphenous Vein Wall in Young Subjects

2000 ◽  
Vol 15 (2) ◽  
pp. 64-70 ◽  
Author(s):  
J. Buján ◽  
F. Jurado ◽  
M. J. Gimeno ◽  
N. García-Honduvilla ◽  
G. Pascual ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Varicose Vein ◽  
Healthy Subjects ◽  
Varicose Veins ◽  
Young Patients ◽  
Proximal Region ◽  
Vein Wall ◽  
Immunohistochemical Markers ◽  
Young Subjects ◽  
Process Characteristic

Objective: An evaluation of the proteoglycan perlecan, collagen I and III, and metalloproteinases MMP−1, −2, −3 and −9 was performed to explore the possible relationships between ageing, affected vein region and reactive state of the varicose vein wall. Methods: Segments of saphenous vein were obtained from healthy subjects and from those with varicose veins. The vein specimens were subdivided according to subject age (<50/^50) and vein source (distal/proximal). Results: The walls of control vein specimens acquired a more collagenous appearance with age. These changes were not accompanied by significant modifications in the immunohistochemical markers used. In specimens from young patients, proximal varicose vein segments showed an increase in MMP-1, MMP-2 and MMP-9 expression. Subjects of more advanced age showed an increase in perlecan expression. Conclusion: This increase in MMPs could lead to the acceleration of the final fibrosclerotic process characteristic of the varicose vein wall.

Changes in Metalloproteinase (MMP-1, MMP-2) Expression in the Proximal Region of the Varicose Saphenous Vein Wall in Young Subjects

2000 ◽  
Vol 15 (2) ◽  
pp. 64-70 ◽  
Author(s):  
J. Bujaán ◽  
F. Jurado ◽  
M. J. Gimeno ◽  
N. García-Honduvilla ◽  
G. Pascual ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Proximal Region ◽  
Vein Wall ◽  
Young Subjects

scholarly journals In Vivo and In Vitro Assessment of Human Saphenous Vein Wall Changes

2007 ◽  
Vol 1 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Akram M Asbeutah ◽  
Sami K Asfar ◽  
Hussain Safar ◽  
Mabayoje A Oriowo ◽  
Ihab ElHagrassi ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Maximum Response ◽  
Repeated Measure ◽  
Maximum Diameter ◽  
Vein Wall ◽  
Post Surgery ◽  
Significant Difference

Purpose: To investigate if noradrenaline (NA) and 5-hydroxyptamine (5-HT) drugs induce responses of isolated control and varicose veins are altered by removal of the endothelium. Subjects & Methods: Specimens of the great saphenous vein (GSV) were obtained from 12 subjects with primary varicose veins and 12 subjects from donor vessels at cardiac surgery. A total of 10 normal healthy volunteers were selected for comparison. The diameter changes of GSV during the resting phase, at the end of 5 minutes occlusion, and then every 30 seconds post deflation for five minutes were measured using B-mode ultrasound. Post-surgery the vein sample was collected in a tube of Krebs-Henseleit solution. Results: The repeated measure ANOVA test for the diameter, percent, and difference changes of GSV diameter from maximum diameter at different time intervals showed significance difference within and between all groups. NA and 5-HT produced concentration-dependent contractions of control and varicose saphenous vein segments. There was no significant difference in the potency of NA and for 5-HT, but the maximum response, normalized for tissue weight, was less in varicose vein segments. Removal of the endothelium had no effect on the potency of NA or 5-HT but significantly (p<0.05) reduced the maximum response to NA and 5-HT in varicose vein segments but not to 5-HT in control veins. Conclusion: The venous endothelial damage may cause vascular smooth muscle contractions dysfunction that favours dilatation and secondary valvular insufficiency.

Biochemical and Histological Analysis of Collagen and Elastin Content and Smooth Muscle Density in Normal and Varicose Veins

1992 ◽  
Vol 7 (3) ◽  
pp. 97-100 ◽  
Author(s):  
J. P. Travers ◽  
C. M. Dalton ◽  
D. M. Baker ◽  
G. S. Makin
Keyword(s):  
Smooth Muscle ◽  
Vascular Disease ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Venous Disease ◽  
Vein Wall ◽  
Protein Ratio ◽  
Muscle Density ◽  
Equivalent Position

Objective: Determination of the ratio of collagen and elastin to protein content of varicose/non-varicose veins from calf and determination of collagen, elastin and smooth muscle density of varicose/non-varicose vein walls. Design: Prospective study; control vein samples obtained from amputees for ischaemic vascular disease and varicose vein samples obtained from an equivalent Position following surgical stripping. Setting: Departments of Human Morphology and Vascular Surgery, Queen's Medical Centre, University of Nottingham, UK. Patients: Seven patients with no evidence of venous disease treated by amputation of the lower limb for vascular disease and 12 patients treated for varicose veins by ligation and stripping of the long saphenous vein. Interventions: Vein sections were examined biochemically and histologically using stereological techniques. Main outcome measures: Biochemical quanitfication of collagen, elastin and protein and stereological analysis of collagen, elastin and smooth muscle density of varicose and non-varicose veins. Results: There was no difference between the collagen/Protein or elastin/protein ratio in varicose and normal veins but there was a significant increase in muscle density with corresponding decrease in collagen and elastin density in the walls of varicose veins compared with non-varicose vein controls. Conclusions: There were no differences in the collagen or elastin content of varicose veins when compared with non-varicose veins. Smooth muscle hypertrophy occurs in varicose veins, which appears to disrupt the collagen/elastin lattice of the vein wall.

scholarly journals Expression of Constitutive Nitric Oxide Synthase Isoforms in Varicose Vein Wall; Preliminary Results

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Zora Haviarová ◽  
Andrea Janegová ◽  
Pavel Janega ◽  
Štefan Durdík ◽  
Peter Kováč ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Nitric Oxide Synthase ◽  
Varicose Vein ◽  
Structural Changes ◽  
Varicose Veins ◽  
Control Group ◽  
Color Analysis ◽  
Vein Wall ◽  
Oxide Synthase ◽  
Nos Isoforms

There are conflicting findings in literature about the structural changes of the primary varicose veins. NO (a potent vasodilatator) is synthesized by nitric oxide synthase (NOS). From 3 known NOS isoforms the two are constitutional: eNOS (endothelial NOS) and nNOS (neuronal NOS). 10 varicose and 10 control vein samples were processed by standard light microscopy and immuno-histochemica techniques using rabbit polyclonal antibodies against eNOS and nNOS. Antibodies expression was evaluated semiquantitatively and proved morphometrically by 2D-image analysis. total area of NOS isoforms expressions was determined by color analysis and color digital subtraction. The results showed discontinuous and significantly lower expression of both NOS isoforms the in the tunica media of varicose veins compared with the control group. For the statistical analysis the unpaired -test was used. Our results suppose lower NO levels in varicose vein wall, deducing that varicose dilatation is due to other mechanism, and they contradict the results of previously published similar works.

Mechanisms of varicose vein formation: valve dysfunction and wall dilation

2008 ◽  
Vol 23 (2) ◽  
pp. 85-98 ◽  
Author(s):  
J D Raffetto ◽  
R A Khalil
Keyword(s):  
Varicose Vein ◽  
Structural Integrity ◽  
Cell Injury ◽  
Varicose Veins ◽  
Venous Pressure ◽  
Venous Disease ◽  
Vein Wall ◽  
Valve Dysfunction ◽  
Functional Changes ◽  
Vein Formation

Varicose veins are a common venous disease of the lower extremity. Although the mechanisms and determinants in the development of varicosities are not clearly defined, recent clinical studies and basic science research have cast some light on possible mechanisms of the disease. In varicose veins, there are reflux and incompetent valves as well as vein wall dilation. Primary structural changes in the valves may make them ‘leaky’, with progressive reflux causing secondary changes in the vein wall. Alternatively, or concurrently, the valves may become incompetent secondary to structural abnormalities and focal dilation in vein wall segments near the valve junctions, and the reflux ensues as an epiphenomenon. The increase in venous pressure causes structural and functional changes in the vein wall that leads to further venous dilation. Increase in vein wall tension augments the expression/activity of matrix metalloproteinases (MMPs), which induces degradation of the extracellular matrix proteins and affect the structural integrity of the vein wall. Recent evidence also suggests an effect of MMPs on the endothelium and smooth muscle components of the vein wall and thereby causing changes in the venous constriction/relaxation properties. Endothelial cell injury also triggers leukocyte infiltration, activation and inflammation, which lead to further vein wall damage. Thus, vein wall dilation appears to precede valve dysfunction, and the MMP activation and superimposed inflammation and fibrosis would then lead to chronic and progressive venous insufficiency and varicose vein formation.

The venous valve agger and plasma noradrenaline-mediated venodilator feedback

2007 ◽  
Vol 22 (3) ◽  
pp. 116-130 ◽  
Author(s):  
T P Crotty
Keyword(s):  
Saphenous Vein ◽  
Varicose Veins ◽  
Feedback Effect ◽  
Venous Valve ◽  
Venous Tone ◽  
Vein Wall ◽  
University Departments ◽  
Perfusion Studies

Objective: To investigate the structure and function of the venous valve agger, a fibroelastic structure located at the base of every valve in veins that are responsive to noradrenaline (NA). Design: Constant flow perfusion studies of the responses of in situ and in vitro canine lateral saphenous vein segments to NA and electrical stimulation, supplemented by histological studies of the segments. Setting: University Departments of Physiology and Histology. Materials: Segments of canine lateral saphenous vein. In vitro = 84, in situ = 60 plus. Results: The agger is a crescentic fibroelastic sleeve, spanning the vein wall very obliquely through which the local vasa venarum network drains. It has a dedicated musculature which, when the tone rises, contracts and stretches the fibroelastic of the agger and opens the drainage channels to reflux. Each agger has four muscles, two each of which insert on the concave and convex margins of the agger. They pull in opposite directions when they contract. Conclusions: The agger forms part of a complex that, in conjunction with its dedicated musculature, a reversible transmural pressure gradient and physiological turbulence in the valve sinuses, positively facilitates drainage from the local segment of the vasa venarum network when venous tone is normal; and when venous tone is elevated it pumps and sucks blood from the lumen of the vein to perfuse the vasa venarum network. When the plasma NA in the perfusate diffuses from the network, it causes a localized venodilator feedback effect that restores the elevated tone of the vein to normal. The feedback effect is potent, being estimated to reduce the venonstrictor effect of neuronal NA by about 50% when flow is laminar and considerably more when flow is turbulent. There is evidence that plasma NA may constitute the lateral inhibitory component of the NA chemostimulus of the smooth muscle cell, neuronal NA constituting the excitor component. A chronic breakdown in agger function is believed to be the cause of varicose veins.

Standard varicose vein surgery

2009 ◽  
Vol 24 (1_suppl) ◽  
pp. 34-41 ◽  
Author(s):  
J M T Perkins
Keyword(s):  
Venous Thromboembolism ◽  
Wound Infection ◽  
Nerve Injury ◽  
Vascular Injury ◽  
Saphenous Vein ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Popliteal Fossa ◽  
Varicose Vein Surgery ◽  
Different Types

This article examines the practice of standard varicose vein surgery including sapheno-femoral and sapheno-popliteal ligation, perforator surgery and surgery for recurrent varicose veins. The technique of exposure of the sapheno-femoral junction and the sapheno-popliteal junction is outlined and advice given on avoidance of complications for both. The evidence regarding methods of closure over the ligated sapheno-femoral junction is examined as is the requirement for stripping and the use of different types of stripper. The requirement to strip the small saphenous vein and the extent of dissection necessary in the popliteal fossa is also examined. Complications of standard varicose vein surgery are outlined. The frequency of wound infection, nerve injury, vascular injury and venous thromboembolism are listed and strategies to avoid these complications are examined.

scholarly journals Factors Associated with Recurrence of Varicose Veins after Thermal Ablation: Results of The Recurrent Veins after Thermal Ablation Study

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
R. G. Bush ◽  
P. Bush ◽  
J. Flanagan ◽  
R. Fritz ◽  
T. Gueldner ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Varicose Vein ◽  
Thermal Ablation ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Time Frame ◽  
Factors Associated ◽  
Perforating Veins ◽  
Contributory Factors ◽  
Ablation Study

Background. The goal of this retrospective cohort study (REVATA) was to determine the site, source, and contributory factors of varicose vein recurrence after radiofrequency (RF) and laser ablation.Methods. Seven centers enrolled patients into the study over a 1-year period. All patients underwent previous thermal ablation of the great saphenous vein (GSV), small saphenous vein (SSV), or anterior accessory great saphenous vein (AAGSV). From a specific designed study tool, the etiology of recurrence was identified.Results. 2,380 patients were evaluated during this time frame. A total of 164 patients had varicose vein recurrence at a median of 3 years. GSV ablation was the initial treatment in 159 patients (RF: 33, laser: 126, 52 of these patients had either SSV or AAGSV ablation concurrently). Total or partial GSV recanalization occurred in 47 patients. New AAGSV reflux occurred in 40 patients, and new SSV reflux occurred in 24 patients. Perforator pathology was present in 64% of patients.Conclusion. Recurrence of varicose veins occurred at a median of 3 years after procedure. The four most important factors associated with recurrent veins included perforating veins, recanalized GSV, new AAGSV reflux, and new SSV reflux in decreasing frequency. Patients who underwent RF treatment had a statistically higher rate of recanalization than those treated with laser.

scholarly journals Are bacteria the main pathological factor in pathogenesis of lower limb varicose veins and non-healing ulcers?

2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Waldemar L Olszewski ◽  
Marzanna T Zaleska ◽  
Ewa Stelmach
Keyword(s):  
Immune Response ◽  
Lymph Nodes ◽  
Granulation Tissue ◽  
Saphenous Vein ◽  
Lower Limb ◽  
Varicose Veins ◽  
Venous Stasis ◽  
Vein Wall ◽  
Delayed Healing ◽  
Primary Damage

Why do the saphenous vein varices arise? According to our concept this is a process of slow deconstruction of the vein wall by inflammation caused by microbes penetrating plantar skin, colonizing deep tissues, entering veins and sticking to valves, as well as, transported to lymphatics, bringing about damage to their wall and evoking immune response in the inguinal lymph nodes. Venous stasis caused by a variety of hemodynamic factors remains secondary to the primary damage of the vein wall. With respect to ulcer, irrespective of the predisposing factors as venous stasis, colonization of the denuded calf surfaces takes place by bacteria drained from foot skin and also those floating down to calf from the perineum. This set of microbes is responsible for progression of ulcer or its delayed healing. In this study, the numerical phenotypes of varicose veins and ulcer granulation tissue bacteria were presented. The dominant strains in the vein walls were Staph. epidermidis and aureus with Enterococci and Pseudomonas frequent in ulcers. High percentage of Staphylococci both in vein walls and ulcer sensitive to antibiotics may suggest that they originated from the microbiome inhabiting leg tissues prior to the development of varices and ulcer.

scholarly journals Vein Glue VenaSeal® for the Therapy in Case of Varicose Vein Thrombosis: A Case Report

2021 ◽  
pp. 1-4
Author(s):  
Zierau UT
Keyword(s):  
Deep Vein Thrombosis ◽  
Case Report ◽  
Saphenous Vein ◽  
Varicose Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Rare Complication ◽  
Vein Thrombosis ◽  
Saphenous Veins ◽  
Deep Vein

The thrombosis in areas of the superficial truncal varicose veins and cutaneous veins is not a rare complication; it requires drug or surgical therapy if the thrombosis grows in the direction of deep veins. This situation is particularly striking in the case of thromboses of the great saphenous vein GSV and small saphenous vein SSV as well as other saphenous veins and leads to deep vein thrombosis in around 20% of cases. We will report about a case of SSV thrombosis and the catheter-based therapy of thrombosis following the therapy of truncal varicose vein SSV with VenaSeal® in one session.

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