CLINICAL AND MORPHOLOGICAL PARALLELS OF CHANGES IN VARICOSE VEIN WALL IN WOMEN OF CHILDBEARING AGE

Research objectives. Clinical assess- ment of microstructural changes in the venous wall at varicose veins in women of childbearing age. Materials and methods. The research was con- ducted in 2015-2018 based on the Chair of Surgery No. 1 of Ivano-Frankivsk National Medical University. Forty- three women aged from 18 to 39 were involved. During the operation, we took fragments of the subcutaneous vein, which was fixed in the neutral formalin solution. The veins were filled with paraffin after dehydration. The wall sections were stained with hematoxylin-eosin and picro-fuchsin according to Van Gieson and studied on a light microscope CARL ZEISS Axiostar-plus. Results and their discussion. During the re- search, minor morphological changes have been found in eight observations (18.6%). The women of this group had a varicose vein disease of С1–С2 clinical class according to CEAP. Microscopic changes were characterized by minor changes in stroma and muscle tissue, the wall structure is saved. This condition is determined as an intermuscular fibrosis, which is a feature of initial mani- festations. Analysis of the clinical research results con- firms this. All patients were under the age of 40 and sought medical attention with compensated manifesta- tions of disease. At the histological study of 23 drugs (53.5%), women with C2 clinical class according to СЕАР had significant changes in the form of hypertrophy of smooth muscles and moderate phlebosclerosis. The sclerotic scarry fields and smooth muscle atrophy with microbleed- ing have been formed in the vein wall. Twelve women (27.9%) with C3 clinical class according to СЕАР had the multiple sclerosis centers of a varicose transformed vein that lost its features: a connec- tive tissue was with the remains of smooth muscles from the intima to adventitia. We noted the hyalinosis of mi- crovasculature arterioles of the vein wall. This reconstruc- tion of the vein wall can be characterized as a scary scle- rosis with hyalinosis and atrophy of smooth muscles. Thus, the pathomorphological presentation of varicose vein wall disease belongs to processes that char- acterize the progression of varicose vein disease and chronic venous insufficiency: from thickening of the vein wall due to edema and intermuscular fibrosis at the initial manifestations of disease to severe connective tissue reconstruction of the entire wall, replacement of the mus- cular component with the dense fibrous connective tissue and hyalineinosis of the walls of arterioles of the micro- circulatory bloodstream at decompensation of the venous return. Conclusions. The degenerative and destructive changes in the form of hyalinosis and replacement of smooth muscle fibers with connective tissue develop at the varicose vein wall progression. Clinical progression of venous insufficiency corresponds to varicose vein wall transformation and correlates with the progression of destructive histological changes in the vein, indicating the irreversible morphological changes.