Abstract
The morphological features of vasa vasorum (VV) of human normal and varicose great saphenous vein (GSV) were studied by use of combination of different anatomical observation methods (injections of India ink and Mercox resin, microdissection, light- and scanning electron microscopy) on embalmed and fresh (peroperatively obtained) material. In normal conditions the system of VV consists of the feeding vessels, branched at the outer surface of GSV into a loose and irregular adventitial network, continuing as a capillary meshwork supplying the outer 2/3 of the media, and continuing as a rich venous network which drains into the adventitial veins.
A direct connection between the VV system and the lumen of GSV was not observed in any case. The intimal hyperplasia was detected regularly in most histological specimens of normal and varicose veins.
No changes of the arrangement of VV were found in primary varicose GSV. On the contrary, impressive changes of their morphology were described in secondary varicose and thrombophlebitic GSV (expressed as maximally developed intimal hyperplasia, degradation of the media, thrombosis), namely in the form of irregular tortuosities and dilatations of adventitial veins, increase of VV and their ingrowth into the deepest layers of the media and into the hyperplastic intima as well as into the organizing thrombi.
The authors conclude that the changed morphology and increase of VV belong to the secondary reactions on the preceding pathomorphological changes of the GSV wall, and therefore they can not be included to the primary varicogenic factors