Connective tissue accumulation in the muscle layer in normal and varicose saphenous veins.

Varicose veins alternate areas of phlebosclerosis and hypertrophy of the vein wall. In this study, samples of long saphenous veins obtained from patients submitted for aortocoronary saphenous vein graft or for surgical resection of varicose saphenous veins were examined. Histologic changes in the intima, muscle, and adventitial layers were quantified. Thicknesses of the venous wall layers were obtained by linear measurements, and the volumetric density of the connective tissue in the muscle layer was determined by point counting. The muscle layer thickness was 300 +/- 13 and 581 +/- 25 microns in normal and varicose veins, respectively. A more severe connective tissue accumulation within the muscle bundles was found in the varicose condition. The volumetric density of the connective tissue in the circular muscle layer (CmC/MmC) showed also a marked difference between varicose (0.67 +/- 0.08) and normal veins (0.43 +/- 0.02), P < 0.05. The authors suggest that the varicose condition is associated with a connective tissue uniform accumulation among muscle cells in the circular muscle layer.

[Histochemical study of elastic system fibers of the walls of normal and pathological saphenous veins]. / Etude histochimique des fibres du système élastique dans les parois des veines saphènes normales et pathologiques.

Normal, varicose and phlebitic saphenous veins were studied by histochemical methods to establish the qualitative variations of their structural components. The histologic preparations were stained by hematoxylin-eosin Gomori's trichrome, orcinol-neofuchsin and resorcin-fuchsin. Normal saphenous vein showed two layers of smooth muscle cells--an internal circular and an external longitudinal. The components of the elastic system were found in the three layers. Elastic fibers were present in the adventitia under an elongated and wavy conformation. In the media they were present in the external portion. Elaunin fibers were found in the media and intima. The oxytalan fibers were not consistently found. The media and intima of varicose veins showed contracted smooth muscle cells associated with fragmented elastic fibers and augmentation of elaunin fibers. In cases of thrombophlebitis the same alterations observed in varicose veins were found together with a decrease of elastic system fibers in the media and intima. The muscle cells showed a loss of their morphologic characteristics.