Changes in the wall of the great saphenous vein at consecutive stages in patients suffering from chronic vein disease of the lower limbs

Abstract

The aim of the study was to show the changes in the great saphenous vein (GSV) wall at consecutive stages in the development of chronic vein disease (CVD) in patients qualified for a surgical procedure after physical examination and Doppler ultrasonography. Four groups of patients were formed (C2, C3, C4 and C5/6) according to clinical stage of the CEAP classification (C - clinical signs, E - aetiopathology, A - anatomy and P - pathophysiology). After the surgical procedure for removal of the varicose GSVs, 40 segments were harvested from their proximal parts near the saphenofemoral junction, 10 segments for each CEAP group. The veins were sectioned transversally and stained with the resorcin-fuchsin and AZAN method to visualise the elastic end collagen fibres. Afterwards the specimens were analysed under an optical microscope and photographed. As the GSV is an elastic vessel and its wall is divided into three zones, namely the internal layer (intima), the medial layer (media) and the external layer (adventitia), we found a proliferation of the connective tissue among the smooth muscle cells inside the internal and medial layers at consecutive stages of CVD. The later stages of CVD also revealed a larger number of the elastic and collagen fibres inside the intima and media and a looser arrangement of the smooth muscle cells of the media in the GSV wall.