Histological appearances of the long saphenous vein

Abstract

The long saphenous vein is frequently used as a graft in both coronary artery and femoro-distal bypass surgery. The histological changes which are seen after implantation into the arterial system have been well documented in the past, but little attention has been focused on the histological appearances of the donor long saphenous vein prior to grafting. In this study, samples of the long saphenous vein in excess of that required for bypass have been examined. In none of the veins did the histological appearances conform to the described normal. All showed evidence of intimal fibrosis which contained elastic tissue and enmeshed smooth muscle cells. The longitudinal and circular muscle layers showed evidence of muscle cell hypertrophy with increase in intervening connective tissue. Elsewhere, similar histological changes have been attributed to 'arterialization'. This study shows that many of the changes are present prior to grafting and may be important in graft failure.

Smooth Muscle Changes in Varicose Veins: An Ultrastructural Study

“…There was also frequent association between the pathological changes in both the muscle layer and the intima, which suggests that both have a common cause. These findings agree with those of Milroy et al (1989). The conflicting findings in the literature of increases, no changes and decreases in concentrations of smooth muscle in varicose veins, must be treated warily because all could be accompanied by increases in absolute amounts (Travers et al, 1996).…”

“…It is likely that similar cells in veins can do the same (Milroy et al, 1989). The endothelium plays an important role in this migration in that damage to the endothelium is thought to cause the release of PDGF and similar substances (Munro and Cotran, 1988).…”

Conduits Used in Coronary Artery Bypass Grafting: A Review of Morphological Studies

“…34) Various studies report the changes in the vein's morphology prior to its use as a graft in CABG. 35,37,38) The changes reported are as follows: fibrosis of the intima with the presence of elastic fibers, collagen, and smooth muscle cells, causing narrowing of the lumen; elastosis of the internal elastic lamina, and hypertrophy of the longitudinal layer of the tunica media. 35,37,38) These changes may have implications for graft failure, contributing to the development of cell proliferation in the intima, thus causing graft occlusion.…”

“…35,37,38) The changes reported are as follows: fibrosis of the intima with the presence of elastic fibers, collagen, and smooth muscle cells, causing narrowing of the lumen; elastosis of the internal elastic lamina, and hypertrophy of the longitudinal layer of the tunica media. 35,37,38) These changes may have implications for graft failure, contributing to the development of cell proliferation in the intima, thus causing graft occlusion. 35,37) The changes that occur in the intima are associated with the changes in the tunica media; this indicates that there is a common etiology.…”

“…35,37,38) These changes may have implications for graft failure, contributing to the development of cell proliferation in the intima, thus causing graft occlusion. 35,37) The changes that occur in the intima are associated with the changes in the tunica media; this indicates that there is a common etiology. 37,38) Although these injuries are considered part of the aging process, the study by Thiene et al (1980) analyzed 150 SV prior to CABG, dividing patients by age, and revealed that these changes do not correlate with the age of patients.…”