title: Valve disease in chronic venous disorders: a quantitative ultrastructural analysis by transmission electron microscopy and stereology.
abstract: BACKGROUND
  The ultrastructure of venous valves and walls in chronic venous disease was investigated.
  
  
  METHODS
  Consecutive patients were categorised into one of three groups (group A: patients with C1 venous disease in accordance with CEAP (Clinical severity, Etiology, Anatomy, Pathophysiology); group B: C2 and C3; group C: C4, C5 and C6). The terminal or preterminal valve and adjacent vessel wall was harvested from the great saphenous vein. Sections were examined with a transmission electron microscope. The volumes of elastin and of collagen per unit surface area of valve were assessed, as well as the surface endothelium of valve and vessel wall.
  
  
  RESULTS
  The study population consisted of 17 patients. The elastin ratio was analysed by means of stereology. Mean values were: in group A, 0.45 μm3/m2; in group B, 0.67 μm3/m2; in group C, 0.97 μm3/m2. The ratio was similar for collagen (A, 15.7 μm3/m2; B, 26.8 μm3/m2; C, 30.1 μm3/m2). Surface analysis of the valve endothelium and the adjacent vessel wall endothelium showed a trend towards increasing damage with more severe disease.
  
  
  CONCLUSIONS
  With progression of venous disease, the valve elastin content, assessed morphologically, seems to increase, and the endothelium of the venous valve and the vein wall tend to show more damage.
authors: Department of Surgery, Spital STS AG Thun, Switzerland. wolfgang.mouton@spitalstsag.ch
authors: Wolfgang G
authors: WG
authors: Mouton
authors: Anna K
authors: AK
authors: Habegger
authors: Beat
authors: B
authors: Haenni
authors: Stefan
authors: S
authors: Tschanz
authors: Iris
authors: I
authors: Baumgartner
authors: Matthias
authors: M
authors: Ochs
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D002908:Chronic Disease; D003094:Collagen / Q000378:metabolism; D018450:Disease Progression; D004549:Elastin / Q000378:metabolism; D004730:Endothelium, Vascular / Q000378:metabolism / Q000648:ultrastructure*; D005260:Female; D006801:Humans; D008297:Male; D046529:Microscopy, Electron, Transmission; D008875:Middle Aged; D012501:Saphenous Vein / Q000378:metabolism / Q000648:ultrastructure*; D016037:Single-Blind Method; D014648:Varicose Veins / Q000378:metabolism / Q000473:pathology*; D055422:Venous Valves / Q000648:ultrastructure*
chemical_list: D015415:Biomarkers; D003094:Collagen; D004549:Elastin