Endovenous surgery nowadays is a common
practice, leaving vascular surgeons in selected cases (radical venous
surgery in patients with peripheral and coronary occlusive disease)
with no venous grafts for possible future arterial bypass
surgery. The aim of this study was to investigate the biomechanical
properties of human varicose veins, and provide recommendations for
the extent of future venous surgery.
Taking into considerations many variables, patients were divided
according to duplex ultrasonography data into three main groups
(sever venous reflux > 2 seconds, group A; moderate venous reflux
< 2 seconds, group B, and control group, no reflux, group C).
Variants such as gender, vein location (above or below knee level),
standing vein diameter and, disease severity (according to Clinical,
Etiological, Anatomical, and Pathophysiological (CEAP)
classification) were registered.
At the laboratory, a special experimental load-standing bench with a
video camera connected to a computer measured venous internal
pressure, and external diameter. During the
experiments, vein samples were gradually loaded with saline
solution (NaCl 0.9%), raising their internal pressure from 0 to 200
mmHg while maintaining the length of vein specimens constant.
Venous internal pressure was increased
gradually by 20 mmHg increments, holding it constant at each step for
1 minute. Vein specimens, thus, stretched at their in situ length.
Stress, strain and incremental modulus of elasticity in venous wall
calculated at each experimental point.
Results show that stress – strain relationship is non-linear.
Venous diameter increases rapidly until internal pressure reaches 40
mmHg, and any further increase in internal pressure leads to an
increase in vein wall stiffness and modulus of elasticity.
Further evaluation of biomechanical properties
of varicose vein segments and comparison of these properties with the
properties of arterial specimens will assess the possibility of using
multiple vein segments at least sutured end-to-end as arterial bypass
- 3.4. Other publications in conference proceedings (including local)