To assess the wall perfusion in normal and varicose veins.
Design:
Observational study.
Setting:
Departments of vascular surgery of private and public hospitals.
Patients:
Twenty-seven patients undergoing vein surgery (43 long saphenous veins) and eight controls operated on for femoral-popliteal bypass.
Methods:
Laser Doppler flowmetry assessing long saphenous vein wall perfusion 3 cm below the saphenofemoral junction.
Results:
Significantly reduced wall perfusion was shown in varicose long saphenous veins compared with normal veins: 16.3 (SD 10.3) versus 45.4 (SD 14.9); p<0.001.
Conclusion:
Our data suggest a primary or secondary role for lower perfusion within the vein wall in varicose veins.
GeiringerE. Intimal vascularisation and atherosclerosis. J Pathol Bacteriol1951; 63: 201–11.
2.
WolinskiHGlagovS. Nature of species differences in the medial distribution of aortic vasa vasorum in mammals. Circ Res1967; XX:409–21.
3.
WilensSLMalcolmJAVasquezJM. Experimental infarction (medial necrosis) of the dogs' aorta. Am J Pathol1965; 47: 695–711.
4.
BarkerSGTalbertACottamSBaskervillePAMartinJF. Arterial intimal hyperplasia after occlusion of the adventitial vasa vasorum in the pig. Arterioscler Thromb1993; 13: 70–7.
5.
NakataYShionovaS. Vascular lesions due to obstruction of the vasa vasorum. Nature1966; 212: 1258–9.
6.
SottiuraiVFryWJStanleyJC. Ultrastructural characteristics of experimental arterial medial fibroplasia by vasa vasorum occlusion. J Surg Res1978; 24: 169–77.
7.
TaccoenALebardCBorieH, Mesure de la pression en oxygène dans la paroi des veines normales et variqueuses. J Mal Vasc1996; 21 (Suppl C): 259–65.
8.
WerberAHHeistadDD. Diffusional support of arteries. Am J Physiol1985; 248: H901–6.
9.
HeistadDDArmstrongMLAmundsenS. Blood flow through vasa vasorum in arteries and veins: Effects of luminal Po2. Am J Physiol1986; 250: H435–42.
10.
BelcaroGLauroraGCesaroneR, Vasa vasorum visualised by power Doppler in normal and atherosclerotic carotid arteries. Vasa1996; 3: 226–32.
11.
BelcaroGNicolaidesANLauroraG, Laser Doppler flux in the venous wall. Phlebology1996; 11: 68–72.
12.
BigelPTaccoenALebardC. Histopathologie et vascularisation de la veine saphène. J Mal Vasc1996; 21 (Suppl C): 249–52.
13.
LeuAJYannarAPfisterGGeigerMFranzeckUKBollingerA. Mikroangiopathie bei chronischer venöser insuffizienz. Dtsch Med Wschr1991; 116: 447–53.
14.
MichelCC. Principes généraux du transport de l'oxygène dans la paroi veineuse. J Mal Vasc1996; 21 (Suppl C): 239–44.
15.
SacksAH. The vaso vasorum as a link between hypertension and atherosclerosis. Angiology1975; 26: 385–90.
16.
SimonBRKobayashiASWiederhielmCAStrandnessDE. Deformation of the arterial vasa vasorum at normal and hypertensive arterial pressure. J Biomech1963; 6: 349–59.
17.
HeistadDDMarcusMLLawEGArmstrongMLEhrhardtJCAbboudFM. Regulation of blood flow to the aortic media in dogs. J Clin Invest1978; 62: 133–40.
18.
LedevehatCBoisseauMVimeuxMBondouxGBertrandA. Hemorheological factors in the pathophysiology of venous disease. Clin Hemorheol1989; 9: 861–70.
19.
ZuccarelliFChabanelATaccoenASamamaM. Agregation erythrocytaire et stades d'évolution de l'insuffisance veineuse des membres inférieurs. J Mal Vasc1992; 17: 97–101.
20.
VicautEHouXDecuypèreLTaccoenADuvelleroyM. Red blood cell aggregation and microcirculation in rat cremaster muscle. Int J Microcirc1994; 14: 14–21.
21.
OhhashiTYoshinakaY. Physiological roles of vasa vasorum on micro and macromolecular transport through aortic walls with special reference to the topography of atherosclerotic plaques. Ann NY Acad Sci1990; 598: 274–80.
22.
BuerkDGGoldstickTK. Oxygen tension changes in the outer vascular wall supplied by vasa vasorum following adenosine and epinephrine. Blood Vessels1986; 23: 9–21.
23.
CrawfordDWKramschDM. The oxygen environment of the arterial media in early rabbit hypertension. Exp Mol Pathol1988; 49: 215–33.
24.
MartinJFBoothRFGMoncadaS. Arterial wall hypoxia following hypoperfusion through the vasa vasorum is an initial lesion in athrosclerosis. Eur J Clin Invest1990; 20: 588–92.
25.
StefanadisCIKarayannakosPEBoudoulasHK, Medial necrosis and acute alterations in aortic distensibility following removal of the vasa vasorum of canine ascending arota. Cardiovasc Res1993; 27: 951–56.
26.
RoseSSAhmedA. Some thoughts on the aetiology of varicose veins. J Cardiovasc Surg1986; 27: 534–43.
