Vasa venarum of the saphenous veins from the patients with associated metabolic disorders

The aim of the study was to investigate vasa venarum of great saphenous vein and their endothelial proliferation and to evaluate the modification of the microvessel density in case of atherosclerosis and associated diabetes mellitus.

Material and methods. The present study included nine venous fragments of human saphenous veins collected from the patients whose lower limbs were amputated. The causes of the limb ablation were: trauma (1 case) and atherosclerosis complicated with occlusion or thrombosis of the lower limbs arteries (8 cases). There were two cases presenting associated diabetes mellitus among the eight cases of atherosclerosis. Formalin-fixed tissues were paraffin embedded and cut into 3μm transverse sections. The slides were stained by a double immunostaining technique using the monoclonal antibodies anti-CD34 and anti-Ki67. The microvessel density was determined by counting the vessels of three “hot spots” and represented by the average values of three “hot spot” areas divided on the surface of high power field (0.0625 mm2). The endothelial cell proliferation index was calculated as the percentage of all nuclei of Ki67-stained endothelial cells that also co-expressed positive cytoplasmic staining in CD34-positive cells.

Results. Vasa venarum of the examined segments of human great saphenous veins were found both in the adventitia and the tunica media. In case of the traumatic injury of the lower limb the adventitial vasa venarum were 4.5 times more numerous (299 vessels/mm2) than those of great saphenous vein media (64 vessels/mm2). In case of associated metabolic disorders we found increased number of vasa venarum of saphenous vein media, 247±109 vessels/mm2 and 253±51 vessels/mm2, respectively. However, the adventitial microvessel density was lower in case of atherosclerosis (151±23 vessels/mm2) and associated diabetes mellitus (125±3 vessels/mm2). The endothelial cell proliferation index was between 20% and 25% in saphenous vein from the patient with the traumatic injury. Moreover, the proliferation index was higher, ranged between 25% and 30%, in saphenous vein from the patients with metabolic disorders. In the adventitia and the media sprouting and non-sprouting angiogenesis were observed.

Conclusions. Under normal conditions, the microcirculatory vessels predominate in the adventitia, but under pathological conditions (atherosclerosis, diabetes mellitus) the microvessels of the media can exceed numerically the microvessels of the adventitia. The vasa venarum of the tunica media can be located in its outer layer. The Ki67-endothelial proliferation index can be higher (25–30%) in case of the atherosclerosis and associated diabetes mellitus than that in normal conditions (20–25%). The formation of the neovasa vasorum occur through both sprouting and non-sprouting angiogenesis.

The aim of the study was to investigate vasa venarum of great saphenous vein and their endothelial proliferation and to evaluate the modification of the microvessel density in case of atherosclerosis and associated diabetes mellitus.

Material and methods. The present study included nine venous fragments of human saphenous veins collected from the patients whose lower limbs were amputated. The causes of the limb ablation were: trauma (1 case) and atherosclerosis complicated with occlusion or thrombosis of the lower limbs arteries (8 cases). There were two cases presenting associated diabetes mellitus among the eight cases of atherosclerosis. Formalin-fixed tissues were paraffin embedded and cut into 3μm transverse sections. The slides were stained by a double immunostaining technique using the monoclonal antibodies anti-CD34 and anti-Ki67. The microvessel density was determined by counting the vessels of three “hot spots” and represented by the average values of three “hot spot” areas divided on the surface of high power field (0.0625 mm2). The endothelial cell proliferation index was calculated as the percentage of all nuclei of Ki67-stained endothelial cells that also co-expressed positive cytoplasmic staining in CD34-positive cells.

Results. Vasa venarum of the examined segments of human great saphenous veins were found both in the adventitia and the tunica media. In case of the traumatic injury of the lower limb the adventitial vasa venarum were 4.5 times more numerous (299 vessels/mm2) than those of great saphenous vein media (64 vessels/mm2). In case of associated metabolic disorders we found increased number of vasa venarum of saphenous vein media, 247±109 vessels/mm2 and 253±51 vessels/mm2, respectively. However, the adventitial microvessel density was lower in case of atherosclerosis (151±23 vessels/mm2) and associated diabetes mellitus (125±3 vessels/mm2). The

endothelial cell proliferation index was between 20% and 25% in saphenous vein from the patient with the traumatic injury. Moreover, the proliferation index was higher, ranged between 25% and 30%, in saphenous vein from the patients with metabolic disorders. In the adventitia and the media sprouting and non-sprouting angiogenesis were observed.

Conclusions. Under normal conditions, the microcirculatory vessels predominate in the adventitia, but under pathological conditions (atherosclerosis, diabetes mellitus) the microvessels of the media can exceed numerically the microvessels of the adventitia. The vasa venarum of the tunica media can be located in its outer layer. The Ki67-endothelial proliferation index can be higher (25–30%) in case of the atherosclerosis and associated diabetes mellitus than that in normal conditions (20–25%). The formation of the neovasa vasorum occur through both sprouting and non-sprouting angiogenesis.