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Revista Médica Sinergia

2019, Number 02

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Revista Médica Sinergia 2019; 4 (02)

Chronic venous insufficiency and structural changes in the walls of the veins

Faringthon RLO, Sosa VOA

Language: Spanish
References: 44
Page: 3-20
PDF size: 689.89 Kb.


ABSTRACT

Objectives: Among all the manifestations of the circulatory system of return, it is perhaps the chronic venous insufficiency that originates the most demand for consultation. This venous pathology that at first may occur imperceptibly, achieves within its development to generate conditions at the structural level in the venous wall that directly activate a series of symptoms that partially or totally incapacitate the sufferer. This is why the main objective of this review is to identify the best existing evidence on chronic venous insufficiency and structural changes in the vein wall.
Method: bibliographical review, descriptive of longitudinal section and retrospective of the controlled scientific literature based on systematic reviews.
Results: The evidence obtained confirmed that people between 60 and 69 years of age are the most prevalent in the development of CVI, representing 47% of the population studied. Followed by those who range between 70/79 years of age for 26% of the total sample of patients. On the other hand, in terms of sex, the studies evaluated show a higher incidence of CVI in females, representing 65% of the population studied. Regarding the risk factors for the development of the IVC, the studies showed that the non-modifiable ones have the highest incidence. It was possible to see among the authors coincidence with regard to the clinical manifestations that in one way or another regardless of which gave rise to the emergence of CVI, are the symptomatological picture prevailing in this venous pathology. Regarding the structural changes in the walls of the veins as a consequence of the IVC, the authors suggest that these modifications are characterized by the thickening and deformation of the vessel, with an increase in its permeability and loss of its antithrombotic properties. They also describe that in the histological study, endothelial cells with different degrees of alteration are revealed. From the increase of its organelles with the presence of large vesicles and vacuoles, degenerative myeloid bodies and developed cytoskeleton, to cells that have completely or partially detached from the venous wall. The subendothelial region shows great collagen infiltration.
Conclusion: Among the risk factors predisposing to CVI, the studies reviewed include gender, age and family history. They also establish that the female sex is the most prone to the development of this venous pathology and people who are between 60 and 79 years of age. The most evident clinical symptomatology in the IVC is the sensation of heaviness, cramps, pruritus and evening edemas. With regard to the structural changes of the venous wall, the authors describe a thickening at the intimal level and in the middle layer, increase in collagen fibers, decrease in elastics and alteration of the morphology of smooth muscle cells that lose their characteristic orientation.


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