[Routes of arteriovenous shunting of blood in chronic venous insufficiency of the lower limbs].

Morphological studies of the mechanisms of arterio-venous shunting of the blood occurring in the lower extremities in varicose and postthrombic lesions of veins were carried out. Studies of the subcutaneous tissue, superficial and binding veins, skin, fasciae, lymphatic nodes, skeletal muscles resected in the course of 152 radical operations in connection with varicose and postthrombic afflictions, showed that in the paravasal tissue of varicose veins and in the sclerosing subcutaneous tissue of the crus anastomoses of the obturator artery type developed. Their formation was connected with compensation of the regional circulation rate due to atrophy of capillary networks in the process of sclerosis. Moreover, a pathological arterio-venous discharge may also take place in the course of organization of thrombosis and origination of the communication between trophic vessels of the wall and the lumen of the recanalized vein. These findings should be considered in selecting a therapeutic strategy in chronic venous insufficiency of the lower extremities.