Superficial Veins Of Lower Extremities Research Articles

ЗНАЧЕНИЕ ГОНАРТРОЗА В РАЗВИТИИ ВАРИКОЗНОЙ БОЛЕЗНИ НИЖНИХ КОНЕЧНОСТЕЙ

Objective: To evaluate the role of arthritis of the knee joint in the development and progression of varicose veins of the lower extremities. Methods: An observational cross-sectional cohort study was conducted on 180 patients. There were 56 (31.1%) males and 124 (68.9%) females with VVs of the lower extremities. The VVs' clinical features were studied according to the presence or absence of knee osteoarthritis. The study group (SG) included 88 patients with KOA in combination with VVs. The control group (CG) comprised 92 people suffering from VVs and not having a degenerative joint disease of the knee. Both groups of patients were comparable in terms of basic demographic parameters, disease duration and body mass index. Results: In the SG, oedema and skin trophic changes of the lower limbs (lipodermatosclerosis, eczema) were observed in 39 and 21 cases, respectively. The number amounts to 68.2%, which was 33.4% more compared to the percentage of the CG cases (34.8%, n=32). In the presence of KOA, a varicose transformation of both saphenous veins and their tributaries was more often noted in 36 (40.9%) cases, whereas in CG patients, VVs development occurred only in 6 (6.5%) cases. On the contrary, an isolated varicose transformation of the great saphenous vein (GSV) and its tributaries was more common among CG compared to SG patients, at 93.5% and 55.7%, respectively. Among the examined cohort, the incidence of isolated disease of the small saphenous vein (SSV) and insufficiency of its ostial valve had no significant difference between SG and CG patients and occurred in 3.4% and 6.5% of cases, respectively. In SG patients, concurrent incompetence of the ostial valves of the GSV and SSV (n=39; 44.3%) and insufficiency of leg perforating veins (n=60; 68.2%) were more often noted. In the CG, perforator reflux and incompetence of the communicating veins were present only in 6 (6.5%) and 32 (34.8%) patients, respectively. The mean GSV ostial diameter in SG and CG patients was significantly different and amounted to 12.1±1.4 mm and 8.2±0.9 mm, respectively. Varicose dilatation of the superficial veins of both lower extremities was most often noted in the SG than in CG, 90.9% and 39.1% of the patients, respectively. There was a direct correlation between the KOA stage and such factors as VVs class (r=0.58; p<0.001), the laterality of lower limbs involvement (r=0.63; p<0.001) and disease recurrence (r= 0.59; p<0.001). Conclusion: Degenerative joint disease of the knee, in which the locomotor function of the limb is impaired, can act as one of the risk factors for the development or progression of varicose transformation of the superficial veins of the lower extremities. Therefore, further research is needed to study the lower limb biomechanics in patients with VV, with and without KOA. Keywords: Varicose veins, knee osteoarthritis, venous hypertension, ostial valve incompetence.

Features of structural and functional parameters of superficial veins of lower extremities in men with arterial hypertension

The aim of the work was to assess the structural and functional parameters of the superficial veins of the lower extremities in men with arterial hypertension. A comparative analysis of the results of the angioscanning of the superficial veins of the lower extremities between 60 men with arterial hypertension and 27 men with normal blood pressure at the age of 30–50 years was performed. In hypertension, an increased rate of venous blood flow and signs of chronic vein diseases are recorded — an increased diameter and area of the lumen of the veins; abnormal venous reflux marked in 10 % of men; in 3 % — varicose veins and thrombotic masses, signs of postrombotic lesion of the superficial veins.Conclusion. For men with hypertension aged 30–50 years, there is an increased rate of venous blood flow and signs of chronic venous disease of the lower extremities: chronic venous insufficiency, varicose and postrombotic venous disease, which must be considered when stratifying cardiovascular risks and treating hypertension.

Frequency of Superficial and Deep Vein Thrombosis in Patients with Variations of Superficial Veins of Lower Extremities

Anatomical variations of veins often play a crucial role in formation of thrombotic changes in superficial and deep veins of lower extremities. THE AIM of this study was to determine the frequency of the dominant type of the lower extremity superficial veins, and to determine the eventual influence of such variations to the formation of superficial and deep vein thrombosis (DVT). The sample used in this study consisted of 180 patients subjected to ascedent contrast phlebography of lower extremities. The total sample was divided into following groups: patients with and without variations of the lower extremity superficial veins. Dominant type of the superficial veins (without variation) consisted of 97 patients (53.89%), while the rest of 83 patients showed some kind of anatomical variation (46.11%). The most frequent variation was the duplicated form ofv. saphena magna in 53.85%, while this procentage in women was 57.89%. Most frequent variations of duplicated v. saphena magna were: simple duplicated form, closed loop form, branching form and combined form. Topographical variation of saphenopopliteal junction besides fossa poplitea in the group of men showed procentage of 53.85%, while in the group of women that value accounted 63.16%. The percentage of varicose veins was more frequent in men and women without variations, but deep vein DVT showed higher frequency in patients with anatomical variations of superficial veins of lower extremities.

Morphological features of vasa vasorum in pathologically changed human great saphenous vein and its tributaries

The question whether the primary increase of vasa vasorum (VV) of venous wall (i) plays an initial role in varicogenesis or (ii) is an expression of impairment of the nutritional conditions in superficial veins of lower extremities is not unambiguously solved yet. The aim of the study was to describe the arrangement of the VV within the wall of the human great saphenous vein (GSV) qualitatively, and of its tributaries at different stages of varicosis and in other pathological states like thrombophlebitis or phlebosclerosis. 22 patients deserving an aorto-coronary bypass surgery or GSV surgery were subdivided into three groups according to the staging of their varices and other pathology. The harvested GSV were prepared for light and scanning electron microscopy. One cadaverous specimen of GSV was injected with India ink. In specimens from reticular and primary large varices local intimal hyperplasia was regularly found, partially accompanied with a mild increase of VV. Tortuosities and irregular dilations of adventitial veins were also found. In patients with recurrent primary varices or thrombophlebitis severe intimal and medial hyperplasia, thrombosis and a striking increase of VV were found. The intima remained avascular in all cases. Remarkable increase of VV accompanies the most severe forms of varices as well as all cases of the extreme grades of phlebosclerosis, medial hyperplasia and thrombosis. We hypothesize that this increase in VV is rather a secondary vascular reaction to the impaired metabolic conditions within the venous wall than a primary varicogenic factor.