Varicose Veins Clinical Trial
Official title:
Clinical and Pathological Correlations in Chronic Venous Disease
Chronic Venous Disease (CVD) has a high prevalence in the general population of the western world. Varicose veins are the main signs of this disease that are characterized by important pathological vessel wall changes. There are also several symptoms that affect the quality of life of affected patients. The aim of this study is to correlate the main histopathological abnormalities with the type and the intensity of the symptoms.
Chronic Venous Disease (CVD) of the lower limbs is a widespread chronic condition of the
western world. There are several signs and symptoms that affect quality of life of patients
with CVD. One of the main signs of this disease are varicose veins that are enlarged,
swollen, and twisting superficial veins. Vessel wall of varicose veins shows a significant
histopathological phenotype, characterized by a distortion of structural architecture:
endothelial damage, disorganization of muscle bundles and alteration of the composition of
the extracellular matrix (ECM). Symptoms may be different, according to disease state,
progression and local inflammatory processes. To date, there is no study that correlate the
type and the intensity of symptoms with histopathological phenotype.
Aim of this study is to correlate histopathological phenotype with clinical manifestations.
A cohort of patients with varicose veins scheduled for open surgical treatment that will
undergo to stab avulsion of varicose veins will be recruited. Subsequently, venous tissue
from stab avulsion will collected in order to evaluate the following biomarkers: VEGF
(Vascular -Endothelial Growth Factor), PGP 9.5 (Protein Gene Product 9.5), Fibronectin and
Matrix Metalloproteinase- 9 (MMP-9).
VEGF has a key role as a regulator of angiogenesis; its expression is highly regulated by
hypoxia, in this case induced by venous hypertension. In addition to being a marker of
neoangiogenesis, it increases vascular permeability in inflammatory disorders. PGP 9.5 is a
marker of the innervation of the vessel wall that plays an important role in the regulation
of venous tone. Fibronectin and MMP-9 are direct markers of ECM remodeling and impairment and
they have also a role in chronic inflammation.
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