Evaluation of the efficacy of foam sclerosant after addition of glycerine on human great saphenous vein: histological and immunohistochemical study
| Autor: | Aam Solaiman, M M Mady, I Atta, Ahmed Sawaby, S Maklad, A. M. El Abd |
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| Rok vydání: | 2021 |
| Předmět: |
Glycerol
Pathology medicine.medical_specialty Polidocanol macromolecular substances 030230 surgery Muscle Smooth Vascular Varicose Veins 03 medical and health sciences 0302 clinical medicine Varicose veins medicine Edema Humans Saphenous Vein Endothelium Viscosity business.industry Great saphenous vein Histology General Medicine Immunohistochemistry Sclerosing Solutions Actins Platelet Endothelial Cell Adhesion Molecule-1 Drug Combinations Treatment modality Surgery medicine.symptom business |
| Zdroj: | The Annals of The Royal College of Surgeons of England. 103:452-458 |
| ISSN: | 1478-7083 0035-8843 |
| DOI: | 10.1308/rcsann.2020.7130 |
| Popis: | Introduction Several treatment modalities have been postulated to improve the efficacy of varicose vein treatment. Addition of glycerine to the sclerosing material has been documented to increase its viscosity and subsequently prolong the duration of stability, in addition to the direct sclerosing effect of glycerine. This histological and immunohistochemical study investigated the efficacy of addition of glycerine 72% to sclerotherapy on the human varicose vein. Methods After surgical stripping of great saphenous veins, three equal segments were resected between two clamps. Specimen 1 was injected with saline only, specimen 2 was exposed to foam sclerosant 2%, and specimen 3 was exposed to a mixture of foam sclerosant 2% and glycerine 72%. All segments were left for 5min. Vein segments were then processed for histological and immunohistochemical study. Results Microscopically, haematoxylin and eosin-stained specimen 1 showed endothelial swelling, cytoplasmic eosinophilia and pyknotic nuclei. The media showed sarcoplasm vacuolisation and necrosis. Specimen 3 showed hypereosinophilic sarcoplasm of the smooth muscle fibres. Oedema was less evident, with a relative decrease in the thickness of the wall compared with specimen 2. Immunohistochemically, the expression of smooth muscle actin was weak in specimen 3 compared with specimens 1 and 2. Expression of CD31 antibody was much reduced in specimen 2 which showed conserved islands of endothelial cells. By contrast, there was a complete loss of endothelial cells in specimen 3. Conclusion Addition of glycerine 72% to foam sclerosant has a more damaging effect on human vein wall. |
| Databáze: | OpenAIRE |
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