The changes of the smooth muscle cells of the varicose veins

Abstract

All authors agree that fibrosis extends from the intima to the adventitia, is the preliminary lesion of the varicose process, and disorganizes the structure of the wall. Also, the atrophy and destruction of the SMC are considered essential by some authors. This study aimed to identify the ultrastructural changes in the media layer of the varicose veins, especially the chronology of SMC degeneration. A proximal section (from the first five cm) of 20 Long Saphenous veins belonging to patients with saphenous-femoral reflux was obtained and processed for TEM according to habitual techniques. Although in the samples studies there are both the contractile and metabolic SMC their degeneration seems to obey two different patterns. destruction of the metabolic SMC is begun in the perinuclear zone, and it expands to the remaining sarcoplasm that on occasion seems totally busy by vesicles, giving a typical image of cellular degeneration. On the other hand, in the contractile SMC is appreciated a sectional loss of the membrane, more evident in the free organules regions. In the last term, we can appreciate the typical morphology of SMC integrated into the extracellular matrix. The results of this study agree with the idea that SMC degeneration is part of the alteration of the vein wall in chronic venous insufficiency, but this destruction has different patterns, apparently according to the predominant phenotype of the cell.