Affiliation:
1. Sechenov First Moscow State Medical University (Sechenov University)
2. Russian Medical Academy of Continuous Professional Education
3. Vishnevsky National Medical Research Center of Surgery
4. Yevdokimov Moscow State University of Medicine and Dentistry;
Loginov Moscow Clinical Scientific Center
5. Loginov Moscow Clinical Scientific Center
Abstract
Introduction. There is a growing number of people over 60 years old and consequently a growing number of elderly and senile patients with varicose veins globally. These patients have involutive changes that occur in the body, and therefore they need a special and personalized approach to examination and treatment. Aim. Study and evaluate age-related and varicose disease-related structural changes in the inner lining of the large subcutaneous vein. Materials and methods. 135 fragments of the large subcutaneous vein were examined, 55 of which belonged to deceased people who had no venous disease, 80 operated patients with varicose veins. There are 4 age groups: young, middle, elderly and senile. Histological, morphometric and electron microscopic examination was performed. Results and discussions. The study showed that involutive changes are characterized by a decrease in the number of endothelial cells along the inner perimeter and their flattening, loosening and edema of the subendothelial stroma in persons over 75 years of age. In varicose veins, morphological changes progress with increasing patient age and disease duration. In young and middle-aged people with varicose veins, endotheliocytes flatten, protrude into the lumen of the vessel, collapse, areas of endothelial atrophy appear along the perimeter, signs of myoelastofibrosis appear, as indicated by an increase in the volume fraction of intima due to connective-woven structures. In patients over 60 years of age, endothelial desquamation is more evident in intimacy, the preserved cells are destructively changed, the volume fraction of intima significantly decreases, which corresponds to the signs of intima sclerosis. Conclusions. Under normal conditions in senile age, the volume fraction is significantly reduced compared to the middle age group (p < 0.005). In case of varicose veins, structural changes, both qualitative and quantitative, progress against the background of involutive changes and disease duration, which aggravates endothelial dysfunction.
Subject
Urology,Surgery,Gastroenterology,Cardiology and Cardiovascular Medicine,Anesthesiology and Pain Medicine
Reference23 articles.
1. Rabe E, Guex JJ, Puskas A, Scuderi A, Fernandez Quesada F. Epidemiology of chronic venous disorders in geographically diverse populations: results from the Vein Consult Program. Int Angiol. 2012;31(2):105–115. Available at: https://www.minervamedica.it/en/journals/international-angiology/article.php?cod=R34Y2012N02A0105.
2. Vuylsteke ME, Thomis S, Guillaume G, Modliszewski ML, Weides N, Staelens I. Epidemiological study on chronic venous disease in Belgium and Luxembourg: prevalence, risk factors, and symptomatology. Eur J Vasc Endovasc Surg. 2015;49(4):432–439. https://doi.org/10.1016/j.ejvs.2014.12.031.
3. Dibirov MD, Magdiev AKh. The treatment of venous trophic ulcers in the elderly patients. Flebologiya. 2016;10(4):224–228. (In Russ.) https://doi.org/10.17116/flebo2016104224-228.
4. Pocock ES, Alsaigh T, Mazor R, Schmid-Schönbein GW. Cellular and molecular basis of Venous insufficiency. Vasc Cell. 2014;6(1):24. https://doi.org/10.1186/s13221-014-0024-5.
5. Travers JP, Brookes CE, Evans J, Baker DM, Kent C, Makin GS, Mayhew TM. Assessment of wall structure and composition of varicose veins with reference to collagen, elastin and smooth muscle content. Eur J Vasc Endovasc Surg. 1996;11(2):230–237. https://doi.org/10.1016/s1078-5884(96)80058-x.