Journal
VASA-EUROPEAN JOURNAL OF VASCULAR MEDICINE
Volume 43, Issue 2, Pages 88-99Publisher
VERLAG HANS HUBER HOGREFE AG
DOI: 10.1024/0301-1526/a000335
Keywords
Varicose veins; shear stress; circumferential; wall tension; endothelial cells; vascular smooth muscle cells; remodelling
Categories
Funding
- German Research Foundation (DFG)
- German Centre for Cardiovascular Research (DZHK)
- European Commission and the German Cardiac Society (DGK)
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The development of varicose veins or chronic venous insufficiency is preceded by and associated with the pathophysiological remodelling of the venous wall. Recent work suggests that an increase in venous filling pressure is sufficient to promote varicose remodelling of veins by augmenting wall stress and activating venous endothelial and smooth muscle cells. In line with this, known risk factors such as prolonged standing or an obesity-induced increase in venous filling pressure may contribute to varicosis. This review focuses on biomechanically mediated mechanisms such as an increase in wall stress caused by venous hypertension or alterations in blood flow, which may be involved in the onset of varicose vein development. Finally, possible therapeutic options to counteract or delay the progress of this venous disease are discussed.
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