Histopathological Studies of the Valves of Varicose Veins

Abstract

In order to elucidate the cause and pathology of varicose veins in the lower limb, the terminal valves of the long saphenous vein in 36 patients with varicose veins and ten control cases have been examined by light and transmission electron microscopy. Valve failure in the varicose group was thought to start with a depression in the valvular commissure and to proceed to extension of this depression and expansion of the space between the two valves. It was further thought that, in this group, reversal and tortuosity of the valve cusps, hyperplasia of the collagen fibres and irregularity of the course of elastic fibre layers represented secondary changes. In almost all cases, intimal fibrous thickening was present in the vein wall, and this was histologically similar to so-called phlebosclerosis. It was further confirmed that the degree of intimal thickening was correlated to the disease period, with greater thickening noted at the region under greater pressure load. Phlebosclerosis seemed to be proportional to the size of stress and pressure load time.