Abstract
The histological differences in the structure of the ovarian vein and saphenous veins of the lower extremities during their varicose transformation have been insufficiently studied in the modern literature. The study aims to determine the morphological parallels of the structure of varicose veins in varicose veins of the pelvis and varicose veins of the lower extremities. Fifty histological biopsy specimens of removed veins were examined in women. Of these, 25 large saphenous veins were obtained from patients with varicose veins of the lower extremities and 25 preparations of a resected ovarian vein from 25 women with varicose veins of the pelvis. The preparation was stained with hematoxylin-eosin and by the Van Gieson method, studied by light microscopy. In the study of the preparations, significant structural changes were noted in all layers of the venous wall, both in varicose veins of the pelvis and in varicose veins of the lower extremities in the form of a combination of atrophic, fibroplastic and hypertrophic processes leading to the loss of its functional properties. Depending on the decompensation of pathological processes, 3 morphological forms of lesions of the venous wall structure were revealed. The hypertrophic form was found in 17 (34%) surgery perform women, fibrous - in 13 (26%), atrophic - in 20 (40%). In the group of patients with varicose veins of the pelvis compared with the group of patients with varicose veins of the lower extremities, the prevalence of initial forms of lesion was revealed. There was a correlation between the severity of venous vascular lesions with the duration of the disease and the patient's age, the number of risk predictors and a high body mass index, which was the determining factor in the occurrence of this phenomenon. The results of this study indicate the similarity of the pathological picture of venous lesions, both in varicose veins of the pelvis and in varicose veins of the lower extremities.
Highlights
The histological differences in the structure of the ovarian vein and saphenous veins of the lower extremities during their varicose transformation have been insufficiently studied in the modern literature
The study aims to determine the morphological parallels of the structure of varicose veins in varicose veins of the pelvis and varicose veins of the lower extremities
25 large saphenous veins were obtained from patients with varicose veins of the lower extremities and 25 preparations of a resected ovarian vein from 25 women with varicose veins of the pelvis
Summary
Распределение пациенток с ВБНК по классу С клинической классификации СЕАР было следующим: С3 – 13 (52%) женщин, С4 – 10 (40%), С5 – 2 (8%). Существенные структурные изменения всех составляющих венозной стенки были выражены в послеоперационном материале пациенток обеих групп. Наиболее часто наблюдались такие морфологические феномены, как выраженная гипертрофия и дискомплексация пучков гладких миоцитов во всех оболочках, их миграция в адвентицию и внутреннюю оболочку, депонирование коллагена в интерстициальном пространстве с развитием межмышечного фиброза, явления ангиоматоза с очаговым лимфоцитарным васкулитом мелких сосудов, чередование десквамации и пролиферации эндотелия. При первой форме поражения строение венозной стенки было нарушено с преобладанием гипертрофических изменений. При гипертрофической форме поражения визуализировали изменение внутренней оболочки с утолщением за счет гиалинизированных коллагеновых волокон и интегрированных миоцитов. В стенках изучаемых вен гипертрофической формы наиболее часто обнаруживали изменения в виде выраженной гипертрофии и дискомплексации пучков гладких миоцитов во всех оболочках венозной стенки с их миграцией в адвентициальную и внутреннюю оболочку, чередование десквамации и пролиферации эндотелия В стенках изучаемых вен гипертрофической формы наиболее часто обнаруживали изменения в виде выраженной гипертрофии и дискомплексации пучков гладких миоцитов во всех оболочках венозной стенки с их миграцией в адвентициальную и внутреннюю оболочку, чередование десквамации и пролиферации эндотелия (рис. 1–3)
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