Venous wall weackness pathogenesis in varicose vein disease

Studennikova V.V.

Sechenov First Moscow State Medical University, Ministry of Health of the Russia, Moscow, Russia

Severgina L.O.

Sechenov First Moscow State Medical University, Ministry of Health of the Russia, Moscow, Russia

Sinyavin G.V.

Department of Cardiovascular Surgery and Interventional Cardiology, Sechenov First Moscow State Medical University, Moscow, Russia

Rapoport L.M.

Sechenov First Moscow State Medical University of the Russian Healthcare Ministry, Research Institute of Uronephrology and Human Reproductive Health, Moscow, Russia

Korovin I.A.

Sechenov First Moscow State Medical University, Ministry of Health of the Russia, Moscow, Russia

Venous wall weackness pathogenesis in varicose vein disease

Authors:

Studennikova V.V., Severgina L.O., Sinyavin G.V., Rapoport L.M., Korovin I.A.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2019;(10): 69‑74

DOI: 10.17116/hirurgia201910169

Downloaded: 57

Download PDF (RU)

Contact the author

Table of contents

To cite this article:

Studennikova VV, Severgina LO, Sinyavin GV, Rapoport LM, Korovin IA. Venous wall weackness pathogenesis in varicose vein disease. Pirogov Russian Journal of Surgery. 2019;(10):69‑74. (In Russ.)
https://doi.org/10.17116/hirurgia201910169

Подписка 2025 (Pirogov Russian Journal of Surgery)

Close metadata

Varicose veins of lower extremities, varicocele and varicose dilation of pelvic veins including ovaricovaricocele are the most common non-inflammatory diseases of venous system. The same mechanisms determined varicose dilatation regardless localization of the vein. First of all, these are wall weakness and valvular insufficiency combined with hereditary collagen fiber defectiveness in case of undifferentiated connective tissue syndrome. Imbalance between different types of collagen in vascular wall (especially types I and III) also results wall weakness. Other important mechanisms are smooth muscle cells dysfunction followed by excessive intracellular synthesis and intramuscular fibrosis and imbalance of protease system due to overproduction of metalloproteinases. We consider that different forms of varicose veins (varicose veins of lower extremities, varicocele, ovaricovaricocele) may be unified within one pathology (varicose vein disease).

Keywords:

review

mechanisms of varicose veins formation

varicose veins of lower extremities

varicocele

ovaricovaricocele

genetic factors

syndrome of undifferentiated connective tissue dysplasia

Authors:

Studennikova V.V.

Sechenov First Moscow State Medical University, Ministry of Health of the Russia, Moscow, Russia

Severgina L.O.

Sechenov First Moscow State Medical University, Ministry of Health of the Russia, Moscow, Russia

Sinyavin G.V.

Department of Cardiovascular Surgery and Interventional Cardiology, Sechenov First Moscow State Medical University, Moscow, Russia

Rapoport L.M.

Sechenov First Moscow State Medical University of the Russian Healthcare Ministry, Research Institute of Uronephrology and Human Reproductive Health, Moscow, Russia

Korovin I.A.

Sechenov First Moscow State Medical University, Ministry of Health of the Russia, Moscow, Russia

List of references:

Studennikova VV, Severgina LO, Dzyundzya AN, Korovin IA. Lower extremity varicose veins in childhood and at a young age: Mechanism of development and specific features. Arkh Patol. 2017;79(4):56-60. (In Russ.) https://doi.org/10.17116/patol201779456-60
Tyabut TD, Karatysh OM. Nedifferentsirovannaya displaziya soedinitel’noy tkani. Modern Rheumatology Journal. 2009;3(2):19-23. (In Russ.) https://doi.org/10.14412/1996-7012-2009-534
Yetkin E, Ileri M. Dilating venous disease: Pathophysiology and a systematic aspect to different vascular territories. Med Hypotheses. 2016;91:73-76. https://doi.org/10.1016/j.mehy.2016.04.016
Yetkin E, Kilic S, Acikgoz N, Ergin H, Aksoy Y, Sincer I, Aktürk E, Beytur A, Sivri N, Turhan H. Increased prevalence of varicocele in patients with coronary artery ectasia. Coron Artery Dis. 2005;16(5):261-264. https://doi.org/10.1097/00019501-200508000-00001
Kravtsov YuA, Makarov VI, Sichinava ZA, Polushin OG, Yarovskaya MV. The role of the undifferentiated connective tissue dysplasia syndrome in the relapse of varicocele. Sibirskiy meditsinskiy zhurnal. 2011;3(26):92-96. (In Russ.)
Kiliç S, Aksoy Y, Sincer I, Oğuz F, Erdil N, Yetkin E. Cardiovascular evaluation of young patients with varicocele. Fertil Steril. 2007;88(2):369-373. https://doi.org/10.1016/j.fertnstert.2006.11.119
Lai YW, Hsueh TY, Hu HY, Chiu YC, Chen SS, Chiu AW. Varicocele is associated with varicose veins: A population-based case-control study. Int J Urol. 2015 Oct;22(10):972-975. https://doi.org/10.1111/iju.12843
Jacob MP. Extracellular matrix remodeling and matrix metalloproteinases in the vascular wall during aging and in pathological conditions. Biomed Pharmacother. 2003 Jul-Aug;57(5-6):195-202. https://doi.org/10.1016/s0753-3322(03)00065-9
Ghaderian SM, Khodaii Z. Tissue remodeling investigation in varicose veins. Int J Mol Cell Med. 2012 Winter;1(1):50-61.
Sansilvestri-Morel P, Rupin A, Badier-Commander C, Fabiani JN, Verbeuren TJ. Chronic venous insufficiency: dysregulation of collagen synthesis. Angiology. 2003 Jul-Aug;54(1):S13-S18. https://doi.org/10.1177/0003319703054001S03
Kirsch D, Dienes HP, Küchle R, Duschner H, Wahl W, Böttger T, Junginger T. Changes in the extracellular matrix of the vein wall — the cause of primary varicosis? Vasa. 2000 Aug;29(3):173-177. https://doi.org/10.1024/0301-1526.29.3.173
Birdina J, Pilmane M, Ligers A. The Morphofunctional Changes in the Wall of Varicose Veins. Ann Vasc Surg. 2017 Jul;42:274-284. https://doi.org/10.1016/j.avsg.2016.10.064
Bharath V, Kahn SR, Lazo-Langner A. Genetic polymorphisms of vein wall remodeling in chronic venous disease: a narrative and systematic review. Blood. 2014 Aug 21;124(8):1242-1250. https://doi.org/10.1182/blood-2014-03-558478
Shadrina A, Tsepilov Y, Smetanina M, Voronina E, Seliverstov E, Ilyukhin E, Kirienko A, Zolotukhin I, Filipenko M. Polymorphisms of genes involved in inflammation and blood vessel development influence the risk of varicose veins. Clin Genet. 2018 Apr 16. https://doi.org/10.1111/cge.13362
Mouton WG, Wagner MO, Haenni B, Mouton KT, Ochs M, Tschanz SA. The influence of age on valve disease in patients with varicose veins analysed by transmission electron microscopy and stereology. Vasa. 2018 May 29:1-7. https://doi.org/10.1024/0301-1526/a000714
Jacob T, Hingorani A, Ascher E. Overexpression of transforming growth factor-beta1 correlates with increased synthesis of nitric oxide synthase in varicose veins. J Vasc Surg. 2005 Mar;41(3):523-530. https://doi.org/10.1016/j.jvs.2004.12.044
Shiraishi K, Naito K. Nitric oxide produced in the testis is involved in dilatation of the internal spermatic vein that compromises spermatogenesis in infertile men with varicocele. BJU Int. 2007;99(5):1086-1090. https://doi.org/10.1111/j.1464-410x.2007.06800.x
Studennikova VV, Severgina LO, Tzarichenko DG, Ismailov MT, Korovin IA, Rapoport LM, Zakharov AI, Petrukhina YuV. Current view on the pathogenesis of varicocele and the problem of its recurrence. Urologiya. 2018;1:150-154. (In Russ.) https://doi.org/10.18565/urology.2018.1.150-154
Serra R, Buffone G, Costanzo G. Altered metalloproteinase-9 expression as least common denominator between varicocele, inguinal hernia, and chronic venous disorders. Ann Vasc Surg. 2014;2 8(3):705-709. https://doi.org/10.1016/j.avsg.2013.07.026
Dogan F, Armagan A, Oksay T, Akman T, Aylak F, Bas E. Impact of micronised purified flavonoid fraction on increased malondialdehyde and decreased metalloproteinase-2 and metalloproteinase-9 levels in varicocele: outcome of an experimentally induced varicocele. Andrologia. 2014;46(4):380-385. https://doi.org/10.1111/and.12091
Limaye N, Kangas J, Mendola A, et al. Somatic activating PIK3CA mutations cause venous malformation. American Journal of Human Genetics. 2015;97(6):914-921. https://doi.org/10.1016/j.ajhg.2015.11.011
Raffetto JD, Khalil RA. Matrix metalloproteinases in venous tissue remodeling and varicose vein formation. Curr Vasc Pharmacol. 2008 Jul;6(3):158-172. https://doi.org/10.2174/157016108784911957
Chen Y, Peng W, Raffetto JD, Khalil RA. Matrix Metalloproteinases in Remodeling of Lower Extremity Veins and Chronic Venous Disease. Prog Mol Biol Transl Sci. 2017;147:267-299. https://doi.org/10.1016/bs.pmbts.2017.02.003
Yetkin E, Ileri M. Dilating venous disease: Pathophysiology and a systematic aspect to different vascular territories. Med Hypotheses. 2016;91:73-76. https://doi.org/10.1016/j.mehy.2016.04.016
Gültaşli NZ, Kurt A, Ipek A, Gümüş M, Yazicioğlu KR, Dilmen G, Taş I. The relation between pelvic varicose veins, chronic pelvic pain and lower extremity venous insufficiency in women. Diagn Interv Radiol. 2006 Mar;12(1):34-38.

Close metadata