Morphological changes in the walls of varicose veins of the lower extremities during minimally invasive surgical treatment

Abstract

The vein wall was investigated in the treatment of patients with varicose veins by endovenous laser and radiofrequency ablation. Fragments of removed veins with varicose veins served as material for pathomorphological research. The following histological staining methods were used: hematoxylin and eosin, van Gieson’s picrofuchsin with additional staining on elastica, according to Mallory. It has been shown, that with varicose veins of the lower extremities, pronounced irreversible morphological changes develop in the vein wall in the form of damage to endothelial cells, hypertrophy of all layers of the vein wall, total development of connective tissue in it with impaired collagen structure both in the basement membrane of endothelial cells and in muscle and elastic layers. Changes in the structure of collagen in the vein wall can be traced in all studied groups, which seems possible, since the treatment with minimally invasive methods is carried out against the background of already altered venous trunks. At the same time, injuries in the vein wall are most pronounced when using endovenous laser coagulation of veins and are accompanied by frequent pain in the postoperative period. The latter is confirmed by morphological changes in the form of total necrosis of the vein wall with necrosis and complete desquamation of the endothelium into the lumen of the vessel. Damage to the wall of the vein of the lower extremities, altered by a chronic current process with varicose veins, including its endothelium and all layers, is minimized when using radiofrequency ablation. Accordingly, cicatrization of surrounding fabrics in the zone of action of radiofrequency ablation will pass in more short spaces and with a favourable end for a patient, that it is confirmed by the less number of paresthesias and sickliness on motion a vein in a postoperative period.