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Year 2012 Vol. 20 No 5
GENERAL AND SPECIAL SURGERY
MORPHOLOGICAL CHANGES OF THE PRETERMINAL SECTION OF THE GREAT SAPHENOUS VEIN AT VARICOSE VEINS OF THE LOWER LIMBS
EE “Vitebsk State Medical University”
The Republic of Belarus
Objectives. To estimate the character of the morphological changes in the preterminal section of the great saphenous vein in different terms starting from the disease onset and in various forms of varicose veins.
Methods. Histological preparations of the removed great saphenous vein of 21 patients with the primary varicose veins of the C2-C6 (CEAP) clinical classes were studied. The examination was carried out by means of the light microscopy at magnification. The state of the venous wall and the character of the morphological changes, which were determined according to the severity of the prevailing pathological processes in the intima, media and adventitia, were estimated.
Results. Morphological structural disturbances in the preterminal section of the great saphenous vein were found out to be represented by the combination of elastolysis, atrophic and sclerotic changes, and hypertrophy involving all layers of the venous wall. On the basis of the pathological processes severity 3 nominal types of venous wall changes are singled out: with prevalence of sclerotic changes on the moderate hypertrophy background; with prevalence of atrophic changes and with marked hypertrophic changes. Severity of the connective tissue destruction, sclerotic changes and hypertrophy correlate with the main disease duration if a positive variant correlation is present in case of sclerosis-hypertrophy and a negative one in case of atrophy-sclerosis, atrophy-hypertrophy.
Conclusions. Pathological morphological changes in the preterminal section of the great saphenous vein are detected at early stages including minor forms of the disease. The most marked character of the connective tissue destruction is observed at early terms of the pathology development. While the disease is progressing, prevalence of the sclerotic changes and of hypertrophy is observed on the background of the severity reduction of the destructive processes of the connective tissue. The given changes show the systemic character of the vascular wall lesion at varicose veins and can predetermine the early character of failure development of the terminal valvular apparatus of the great saphenous vein in case of the given pathology.
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210023, Respublika Belarus, g. Vitebsk, pr-t Frunze, d. 27, UO «Vitebskiy gosudarstvennyiy meditsinskiy universitet», kafedra gospitalnoy khirurgii s kursami urologii i detskoy khirurgii
Krishtopov Andrey Leonidovich
Krishtopov A.L. Senior Lecturer of the Hospital Surgery with the Course of Urology and Pediatric Surgery Chair of EE “Vitebsk State Medical University”.
Myadelets O.D. Doctor of Medical Sciences, Professor, Head of the Histology, Cytology and Embryology Chair of EE “Vitebsk State Medical University”.