Mechanisms of varicose vein formation: valve dysfunction and wall dilation

@article{Raffetto2008MechanismsOV,
  title={Mechanisms of varicose vein formation: valve dysfunction and wall dilation},
  author={Joseph D. Raffetto and Raouf A. Khalil},
  journal={Phlebology},
  year={2008},
  volume={23},
  pages={85 - 98}
}
Abstract Varicose veins are a common venous disease of the lower extremity. Although the mechanisms and determinants in the development of varicosities are not clearly defined, recent clinical studies and basic science research have cast some light on possible mechanisms of the disease. In varicose veins, there are reflux and incompetent valves as well as vein wall dilation. Primary structural changes in the valves may make them ‘leaky’, with progressive reflux causing secondary changes in the… 

Figures and Tables from this paper

Varicose Veins: Venous Wall Changes, Inflammation, and Matrix Metalloproteinases

TLDR
The role of venous wall dysfunction appears to precede valve dysfunction, is linked to MMPs, and is tightly regulated by hypoxia inducible factor.

Matrix metalloproteinases as potential targets in the venous dilation associated with varicose veins.

TLDR
With the advent of new genetic and pharmacological tools, specific MMP inhibitors with fewer undesirable effects could be useful to retard the progression and prevent the recurrence of VVs.

The Morphofunctional Changes in the Wall of Varicose Veins.

Role of mechanosignaling on pathology of varicose vein

TLDR
This review article tries to elaborate on the effect of mechanical forces and sensors of these forces on the vascular wall in creating the mechanism of mechanosignaling, as well as the role of the onset of molecular signaling cascades in the pathology of varicose veins.

Mechanisms of Lower Extremity Vein Dysfunction in Chronic Venous Disease and Implications in Management of Varicose Veins.

TLDR
Current lines of treatment including induction of endogenous tissue inhibitors of metalloproteinases (TIMPs) and administration of exogenous synthetic inhibitors of MMPs are being explored, and could provide alternative strategies in the treatment of CVD.

Varicose Veins: Role of Mechanotransduction of Venous Hypertension

  • H. Atta
  • Medicine
    International journal of vascular medicine
  • 2012
TLDR
The current understanding of mechano-molecular pathways involved in transduction of hemodynamic forces induced by blood pressure is summarized and tries to relate this information to setting of venous hypertension in varicose veins.

A different way to look at varicose veins.

  • T. RookeC. Felty
  • Medicine
    Journal of vascular surgery. Venous and lymphatic disorders
  • 2014

Venous Hypoxia: A Poorly Studied Etiological Factor of Varicose Veins

TLDR
Molecular studies have shown that hypoxia was able to cause inflammatory changes and vein wall remodelling similar to those observed in varicosities, and further studies are needed to improve the understanding of the role ofHypoxia and help identify potential therapeutic targets.

Does extracellular matrix of the varicose vein wall change according to clinical stage?

TLDR
It was observed that in the early stages of chronic venous disease, fibrosis is increased in the intima and media layers, with fragmentation in lamina elastica interna, and increased tenascin expression in the Intima layer.
...

References

SHOWING 1-10 OF 82 REFERENCES

[Primary varicose veins--changes in the venous wall and elastic behavior].

TLDR
Results suggest that the role of the venous valves in the development of varicose veins is secondary to changes of the vein wall, and the matrix proteins demonstrated an increase in total fibres, whereas the elastic fibres were reduced and fragmented, explained the rigidity of varices.

Expression of Adhesion Molecules and Cytokines on Saphenous Veins in Chronic Venous Insufficiency

TLDR
Assessment of the relationship of signaling molecules to monocyte/ macrophages as a precursor to venous valve and venous wall dysfunction in patients with varicose veins indicates that not only luminal venous endothelium but also endot Helium in the vasa vasora of refluxing saphenous veins is activated.

Primäre Varicosis – Veränderungen in der Venenwand und im elastischen Verhalten

TLDR
It is suggested that the role of the venous valves in the development of varicose veins is secondary to changes of the vein wall, and the matrix proteins demonstrated an increase in total fibres, whereas the elastic fibres were reduced and fragmented, explained the rigidity of varices.

Varicose veins possess greater quantities of MMP-1 than normal veins and demonstrate regional variation in MMP-1 and MMP-13.

TLDR
MMP-1 protein is increased in varicose veins when compared to controls despite no differences in mRNA expression and posttranscriptional regulatory controls could be responsible for the observed differences.

Changes in the extracellular matrix of the vein wall--the cause of primary varicosis?

TLDR
Comparisons with valve-orientated staging of varicosis showed that compared with normal veins, varicose veins are associated with a significant increase in matrix protein expression for collagen 4, laminin and tenascin.

The venous wall and valvular function in chronic venous insufficiency.

  • O. Thulesius
  • Medicine
    International angiology : a journal of the International Union of Angiology
  • 1996
The present paper is an overview taking into account the four most important etiological factors which can be involved in the development of chronic venous insufficiency (CVI): (1) weakness of the

Venous Hypertension and the Inflammatory Cascade: Major Manifestations and Trigger Mechanisms

TLDR
Evidence has been obtained that venous valve deficiency may be associated with leukocyte infiltration into valve leaflets; therefore, it is hypothesized that an essential event in the inflammatory cascade is the enzymatic degradation of the valve leaflets and venous wall.
...