Venous morphology predicts class of chronic venous insufficiency.
OBJECTIVE
this study aimed to determine specific morphological differences in long saphenous veins from patients with various grades of chronic venous insufficiency.


METHODS
comparable veins from a control group were compared with patients with either primary varicose veins or those with associated skin changes including venous ulcers.


METHODS
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.
Jones
G T
GT
Department of Surgery, Otago Medical School, Dunedin, New Zealand.
Solomon
C
C
Moaveni
A
A
van Rij
A M
AM
Thomson
I A
IA
Galvin
I
I
D000368:Aged; D001783:Blood Flow Velocity; D002452:Cell Count; D002908:Chronic Disease; D004547:Elastic Tissue / Q000000981:diagnostic imaging / Q000473:pathology; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008875:Middle Aged; D011379:Prognosis; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000473:pathology*; D012720:Severity of Illness Index; D018616:Ultrasonography, Doppler, Duplex; D014647:Varicose Ulcer / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D014689:Venous Insufficiency / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology