Morphological features of the great saphenous vein in patients with chronic venous disease of the lower extremities undergoing the most common endovenous treatment techniques

Abstract

Aim: The purpose was to identify the morphological features of the great saphenous vein in patients with chronic venous disease of the lower extremities undergoing treatment with endovenous high-frequency electric welding in automatic mode, endovenous laser ablation, and ultrasound-guided microfoam sclerotherapy. Materials and Methods: The material for the comprehensive morphological study consisted of fragments of the great saphenous vein obtained from 32 patients with chronic venous disease of the lower extremities. The material was divided into three groups according to the endovenous treatment techniques applied. Group 1 included vein fragments from 12 patients who underwent endovenous high-frequency electric welding in automatic mode. Group 2 comprised material from 9 patients treated with endovenous laser ablation. Group 3 included material from 11 patients who underwent ultrasound-guided microfoam sclerotherapy using a 3% polidocanol solution. Histological and immunohistochemical research methods were used. Results: The great saphenous vein in patients with chronic venous disease of the lower extremities undergoing treatment with endovenous high-frequency electric welding in automatic mode and endovenous laser ablation was characterized by similarly pronounced diffuse alterative and desquamative changes in endothelial cells, disruption of the structural organization of the venous wall layers accompanied by edema, and alterative changes in both muscular and connective tissue fibers. In cases where ultrasound-guided microfoam sclerotherapy was applied, the great saphenous vein showed focal alterative and desquamative changes in endothelial cells, preservation of the layered structure, edematous changes in the media and adventitia, focal areas of dysmucoidosis, and regions of angiomatosis. Conclusions: The severity of structural changes in the great saphenous vein in patients with chronic venous disease of the lower extremities following ultrasoundguided microfoam sclerotherapy was significantly lower compared to endovenous high-frequency electric welding in automatic mode and endovenous laser ablation, resulting in less favorable conditions for the qualitative development of the fibrous process.