Surgical correction of valvular insufficiency of deep varicose veins of the lower extremities

A scheme for preoperative examination of the patients with varicose disease is presented. Incompetence of the deep venous valves was revealed in 74.1% of the patients with varicose disease and in 76.5%--with its postoperative recurrences. Correction of ++phlebo-hemodynamics was accomplished by means of a carcass spiral, fascial paravasal structures and suggested by the authors method of placing the three corrective ligatures, which has proved to be the most effective. One hundred and forty two operations on the deep veins were performed in 102 patients. In observation for up to 4 years, in 94.7% the excellent and good results were noted.     

Endovenous therapy for varicose veins of the lower extremities

Endovenous treatment for varicose veins of the lower extremities is an old technique. New technologies such as radiofrequency and laser have revived its indications. Thermal energy which is delivered to the vein wall results in a fibrous retraction and eventually complete obstruction of the vessel.     

下肢静脉曲张血管重塑的研究

目的　探讨下肢静脉曲张血管重塑的实质、特征以及在下肢静脉曲张发生机制中的意义。方法　采用Masson染色、免疫组织化学、电镜观察以及图像分析方法研究 1 8例曲张静脉和1 4例正常静脉壁中平滑肌细胞、胶原纤维、Ⅰ型胶原、Ⅲ型胶原和α actin的结构变化。结果　曲张静脉内膜改变以内膜增生为主 ,中膜以中膜增厚为主 ,平滑肌细胞从收缩表型向合成表型转化。α actin在内膜 (3 .67± 0 .69) %和中膜 (1 2 .0 9± 2 .1 4 ) %的体密度比正常静脉 [(8.91± 0 .94) %和(2 1 .42±1 .49) % ]均显著减少 (P <0 .0 1 ) ;Ⅲ型胶原在内膜 (1 4 .1 0± 0 .93) %和中膜 (1 9.58±1 .51 ) %的体密度比正常静脉 [(8.41± 0 .86) %和 (1 2 .97± 1 .1 5) % ]均显著增多 (P <0 .0 1 ) ;I型胶原中膜的体密度 (2 3 .52± 1 .67) %比正常静脉 (1 6 .2 8± 1 .44) %也显著增多 (P <0 .0 1 )。结论下肢静脉曲张血管重塑的平滑肌细胞异常增生 ,从收缩表型向合成表型转化 ,以及细胞外基质中胶原异常改变 ,都使得管壁收缩效应降低 ,静脉因而易曲张