Light Microscopy,Immunohistochemistry and Electron Microscopy of the Valves of the Lower Limb Veins and Jugular Veins

Abstract

Objectives:

To demonstrate the light, electron microscopy and immunohistochemistry appearances of the valves of lower limb veins and jugular veins of subject with evidence of venous disease.

Design:

A prospective study of saphenous veins obtained at post mortem examination and jugular vein obtained at time of surgery.

Setting:

Health Service district general hospital.

Patients:

Patients with no evidence of venous disease being treated in the hospital for unrelated conditions, or examined at autopsy in the Department of Pathology.

Interventions:

Sections of saphenous vein from the lower limb and jugular vein were examined using conventional histology, immunohistochemical staining and electron microscopy.

Main outcome measures:

Microscopic and electron microscopic appearances of histological sections of venous valves.

Results:

The valve agger contains an increased amount of fibrous tissue compared with the vein wall and saphenous and jugular veins. However, in saphenous veins the muscle layer of the wall could be traced across the base of the agger, but this was deficient in jugular valves. Electron microscopic examination showed that most of the valve cusp was composed of collagen fibrils, aggregated in irregularly arranged bundles. Elastic fibre material was present in the subendothelial zones. Nerve and muscle fibres were not present in the cusp.

Conclusions:

Valve cusps in both high and low pressure systems are similar, and the authors suggest that cusp/agger/vein wall complex is important for valve function.