scholarly journals Morphological changes in the walls of varicose veins of the lower extremities during minimally invasive surgical treatment

2019 ◽  
Vol 84 (3) ◽  
pp. 16-22
Author(s):  
E.G. Cherkasheninov
Keyword(s):  
Endothelial Cells ◽  
Radiofrequency Ablation ◽  
Minimally Invasive ◽  
Postoperative Period ◽  
Varicose Veins ◽  
Morphological Changes ◽  
Lower Extremities ◽  
Laser Coagulation ◽  
Vein Wall ◽  
Minimally Invasive Surgical

The vein wall was investigated in the treatment of patients with varicose veins by endovenous laser and radiofrequency ablation. Fragments of removed veins with varicose veins served as material for pathomorphological research. The following histological staining methods were used: hematoxylin and eosin, van Gieson’s picrofuchsin with additional staining on elastica, according to Mallory. It has been shown, that with varicose veins of the lower extremities, pronounced irreversible morphological changes develop in the vein wall in the form of damage to endothelial cells, hypertrophy of all layers of the vein wall, total development of connective tissue in it with impaired collagen structure both in the basement membrane of endothelial cells and in muscle and elastic layers. Changes in the structure of collagen in the vein wall can be traced in all studied groups, which seems possible, since the treatment with minimally invasive methods is carried out against the background of already altered venous trunks. At the same time, injuries in the vein wall are most pronounced when using endovenous laser coagulation of veins and are accompanied by frequent pain in the postoperative period. The latter is confirmed by morphological changes in the form of total necrosis of the vein wall with necrosis and complete desquamation of the endothelium into the lumen of the vessel. Damage to the wall of the vein of the lower extremities, altered by a chronic current process with varicose veins, including its endothelium and all layers, is minimized when using radiofrequency ablation. Accordingly, cicatrization of surrounding fabrics in the zone of action of radiofrequency ablation will pass in more short spaces and with a favourable end for a patient, that it is confirmed by the less number of paresthesias and sickliness on motion a vein in a postoperative period.

scholarly journals The State of the Hemomycocirculatory Bed of Adventitia of Varicose Veins of the Small Pelvis in Women with Chronic Inflammatory Diseases of the Internal Genital Organs

2017 ◽  
Vol 23 (2) ◽  
Author(s):  
Natalya Drohomyretska
Keyword(s):  
Inflammatory Diseases ◽  
Varicose Veins ◽  
Morphological Changes ◽  
Complex Structure ◽  
The State ◽  
Reproductive Age ◽  
Ovarian Vein ◽  
Women Of Reproductive Age ◽  
Vein Wall ◽  
Inflammatory Processes

Hemomicrocirculatory system – is a complex structure that reacts in every pathological process even before the clinical period and takes the first blow. The study of microhemocirculation will provide an opportunity to solve the important for practical medicine questions of pathogenesis of many diseases, as for the prevention and treatment of regional disorders of blood circulation.The objective of the research is to study the state of the hemomicrocirculatory bed (HMCB) of adventitia of varicose veins of the small pelvis (VVSP) in women with chronic inflammatory processes of the organs of the small pelvis (CIPOSP).Materials and methods of research. To evaluate the restructuring of the HMCB of adventitia of VVSP, the operating material of 12 women of reproductive age was used. Mainly, there were pieces of the ovarian vein. The study of the HMCB in the vein wall was performed by the non-injecting method of silver impregnation according to V.V. Kupriyanov. To standardize the results, the condition of the HMCB of adventitia of the venous wall in norm was studied in 5 women of reproductive age, who died as a result of various traumas.Results of the research. After the performed studies, the structural-morphological changes of the HMCB of the adventitia of the small pelvis veins were revealed. The dilation of capillaries, postcapillaries, postcapillary venules was observed. The diameter of the vessels of the HMCB of the ovarian vein adventitia was: venule – 94.21 ± 1.38 μM in comparison with the norm – 48.78 ± 1.60 μM (p<0.001); post-capillary venules – 46.76 ± 1.04 μM in comparison with the norm – 28.29 ± 1.1.01 μM (p<0.001); the capillaries were 11.22 ± 0.14 μM in comparison with the norm – 8.24 ± 0.16 μM (p<0.05), arterioles – 29.02 ± 0.76 μM in comparison with the norm – 25.19 ± 1.15 μM (p<0.01). The architectonics of the arterioles is almost unchanged. Lumen of venules is filled with formed elements. The structure of capillaries is polymorphic. The capillary net was localized and concentrated or was formed as a thick planar net, the capillaries were expanded. There were arterio-venulous anastomoses. Endothelial nuclei are shortened. In some preparations, the diameter of the arterioles corresponded to the diameter of the collection venules.  Conclusions:1. The first discovered by us changes in HMCB of adventitia of varicose veins of the small pelvis in women with CIPOSP can be one of the pathogenetic links of the development and progression of the varicose vein itself, which in turn aggravates the course of chronic inflammation.      2. The timely appointment of drugs that improve microcirculation will enable to prevent the development of dystrophic changes in the vein wall, improve the course of chronic inflammatory processes and reduce or completely eliminate the syndrome of “chronic pelvic pain”.

scholarly journals Pathophysiological aspects as the object of the treatment tactics in acute pancreatitis (review)

2021 ◽  
Vol 8 (2) ◽  
pp. 87-94
Author(s):  
Igor Kryvoruchko ◽  
Anastasiya Drozdova ◽  
Nataliya Goncharova
Keyword(s):  
Acute Pancreatitis ◽  
Minimally Invasive ◽  
Postoperative Period ◽  
Surgical Trauma ◽  
Fast Track Surgery ◽  
Surgical Interventions ◽  
Minimally Invasive Surgical ◽  
Treatment Measures ◽  
Mechanisms Of Development ◽  
Adequate Management

The review presents a modern view on the features of the course and treatment of acute pancreatitis, based on a cascade of pathophysiological mechanisms of this disease. A number of concepts of development and course of acute pancreatitis on the basis of randomized prospective and retrospective researches devoted to this problem are considered. Attention is paid to the mechanisms of development of organ failure in acute pancreatitis. In accordance with the above, the main positions of treatment measures for acute pancreatitis, which are based on the principles of tactics "step-up approach" were highlighted. Among them, attention is focused on the features of the conservative treatment program, minimally invasive surgical interventions, as well as the management of the postoperative period of patients. Minimally invasive surgical interventions perform the main tasks of surgical treatment in acute pancreatitis, but significantly reduce surgical trauma compared to "open" methods. Adequate management of the postoperative period of patients is carried out through the implementation of protocols "fast-track surgery".

scholarly journals Results of kyphoplasty in the minimally invasive treatment of vertebral metastasis

2014 ◽  
Vol 13 (3) ◽  
pp. 235-238
Author(s):  
Carlos Fernando Pereira da Silva Herrero ◽  
Mario Bressan Neto ◽  
Carlos Eduardo Sargi Godoy ◽  
Vitor Rodrigues Fornazari ◽  
Lilian Maria Pacola ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Vertebral Body ◽  
Postoperative Period ◽  
Spinal Metastases ◽  
Balloon Kyphoplasty ◽  
Vertebral Metastases ◽  
Minimally Invasive Surgical ◽  
Minimally Invasive Surgical Treatment ◽  
The Mean

OBJECTIVE: To evaluate the clinical and radiological outcome of minimally invasive surgical treatment of vertebral metastases using the technique of kyphoplasty. METHODS: This was a prospective observational study of patients with the diagnosis of spinal metastasis who underwent minimally invasive surgical treatment by filling the vertebral body with balloon kyphoplasty technique. Clinical evaluation included patient age at surgery, diagnosis of the tumor, biopsy results, data of the surgical procedure performed, visual pain scale (VAS) and complications related to surgery. Radiological evaluation involved the study of radiographic procedures in the anteroposterior and lateral incidences, with the analysis of vertebral body kyphosis and the occurrence of extravasation of cement. RESULTS: 22 patients with spinal metastases who were treated by balloon kyphoplasty, 8 (36%) males and 14 (64%) females were studied. The average age was 56.05 years and the mean follow-up was 8.5 months. The mean preoperative VAS was 8.73, 1.73 in the initial postoperative period, and 1.92 in the late postoperative period. CONCLUSION: Kyphoplasty proved to be a safe and effective technique for symptomatic treatment of vertebral metastases.

scholarly journals Minimally-invasive procedure for pelvic leak points in women

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Roberto Delfrate ◽  
Massimo Bricchi ◽  
Claude Franceschi
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Lower Limb ◽  
Varicose Veins ◽  
Absorbable Suture ◽  
Pelvic Congestion Syndrome ◽  
Minimally Invasive Surgical ◽  
Hemodynamic Assessment ◽  
Pelvic Congestion

Pelvic leak points (PLP) may be responsible for vulvar, perineal and lower limb varicose veins, in women during and/or after pregnancy. The accurate anatomical and hemodynamic assessment of these points, the perineal (PP), inguinal (IP) and clitoral points (CP) and their surgical treatment under local anesthetics as defined by Claude Franceschi is a new therapeutic option. The aim of this study was to assess the reliability and durability of the PLP reflux ablation using a minimally-invasive surgical disconnection at the PLP level in women with varicose veins of the lower limbs fed by the PLP. In this open-label trial 273 pelvic leak points free of pelvic congestion syndrome, with at least a 12-month follow- up, were assessed. 273 PLP treated: PP (n=177), IP (n =91) and CP (n=5). Followup: Period =12 to 92 months (mean =30.51 months). Age from 29 to 77 years (mean=45). The only 3 patients over 70 years (71, 74, 77) showed a high-speed reflux from a I point that fed symptomatic varicose veins of the lower limb. Exclusion criteria: pelvic congestion syndrome, BMI>24, venous malformations, a post thrombotic varicose vein. Diagnosis was performed using echo duplex and PLPs selected for treatment when refluxing at Valsalva + Paraná + squeezing maneuvers. A surgical skin marking of the PLP had been performed using echo duplex before surgery. Surgery consisted of minimally invasive dissection and selective division and ligation with non-absorbable suture of the refluxing veins and fascias at the PP, IP and CP pelvic escape points, under local anesthesia in a single center. The follow-up consisted of an echo duplex ultrasound, searching for reflux at the PLP treated thanks to the Valsalva maneuver, within 2 weeks, after 6 and 12 months and then yearly. The main endpoint of the study was the immediate elimination of the reflux at the PLP treated. The second endpoint was the long-term durability of the reflux ablation at the PLP treated. 267 (97.8%) without PLP reflux redo. 6 (2.2%) PLP reflux recurrences (PP=4, IP=1, CP 1). 3 patients with PLP reflux recurrence undergo a redo surgery (1.1%) where PP=2 (0.7%) and IP=1 (0.3%). This study shows the feasibility and durability of reflux ablation at the PLP level thanks to a minimally-invasive surgical treatment of the PLP and it demonstrates that there is no need for pelvic varicose embolization in patients without clinical signs of pelvic congestion syndrome. The accurate ultrasound assessment of each specific pelvic leak as well as a special surgical technique (vein division, non-absorbable suture of veins and fascias) seems to be the key for satisfactory outcomes.

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

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

The effects of endovenous radiofrequency ablation on coagulation and the vein wall in an experimental canine model

Vascular ◽  
2013 ◽  
Vol 21 (4) ◽  
pp. 215-219 ◽  
Author(s):  
Wang Tao ◽  
Gu Jian-ping ◽  
He Xu ◽  
Lou Wen-sheng ◽  
Chen Liang ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Plasminogen Activator ◽  
Varicose Veins ◽  
Femoral Vein ◽  
Plasminogen Activator Inhibitor ◽  
Canine Model ◽  
Enzyme Linked Immunosorbent Assay ◽  
Plasminogen Activator Inhibitor 1 ◽  
Vein Wall ◽  
Experimental Canine

Endovenous radiofrequency ablation (RFA) has been introduced as a less invasive alternative to traditional surgery for varicose veins, but vein thrombosis after RFA remains a concern. This study investigated the influence of endovenous RFA on coagulable states of canine blood, and changes in the vein wall and lumen. Eight canines underwent RFA of the iliac-femoral vein. Levels of plasma granule membrane protein-140, tissue plasminogen activator and plasminogen activator inhibitor-1 increased at different time points after RFA, which were monitored by enzyme-linked immunosorbent assay. Venography after ablation showed that there was left iliac-femoral vein occlusion in three canines and vein stenosis in the remaining five. Histological examination revealed intimal injury and inflammatory cell infiltration of the vessel wall. Our findings suggest that RFA is an effective microinvasive technique, which can result in a hypercoagulable state, with venous thrombosis and stenosis.

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