Jobst Vascular Institute, Toledo, OH, USA.
Jobst Vascular Institute, Toledo, OH, USA.
Thromb Res. 2015 May;135(5):882-7. doi: 10.1016/j.thromres.2015.02.026. Epub 2015 Feb 27.
Postthrombotic intraluminal tissue causing postthrombotic syndrome (PTS) has not been well described. This study defines its histological characteristics and assess whether tissue function evolves over time.
Specimens from 18 common femoral veins (CFV) from 16 patients obtained during CFV endovenectomy and iliocaval recanalization were examined. Phase 1 used hematoxylin and eosin and Masson's trichrome stains for collagen, immunohistochemical, and Von Kossa stains. Phase 2 examined young (≤ one year) and mature (≥10years from acute DVT) specimens to evaluate evolution of endothelial function. Antibodies to four biomarkers were used to examine specific functions of endothelial cells lining neovessels and recanalization channels (RC).
Phase 1: Specimens demonstrated 80-90% of collagen type I, 10-20% of collagen type III, and dystrophic calcification. Neovessels and RC were in close proximity to each other. Thrombus and smooth muscle cells were absent, but white blood cells were present. Phase 2: VEGFR2 receptor uptake was more abundant in neovessels than RC and more prominent in younger specimens. Neovascular, nonchannel cells were observed more frequently in young specimens. CD-31 was similar in young and mature specimens. TIE-2 and von Willebrand factor antibodies had greater uptake in mature specimens.
Tissue causing chronic postthrombotic venous obstruction is predominantly type I collagen. Neovascularization and recanalization occur in close proximity. The biomarker for neovascularization and angiogenesis (VEGFR2) was more prominent in young specimens whereas TIE-2, a stabilizing biomarker and vWF were more frequently observed in mature specimens.
引起血栓后综合征（PTS）的血栓后腔内组织尚未得到很好的描述。本研究定义了其组织学特征，并评估了组织功能是否随时间演变。
检查了 16 名患者 18 条股总静脉（CFV）在 CFV 静脉内切除术和髂股再通术中获得的标本。第 1 阶段使用苏木精和伊红以及 Masson 三色染色法进行胶原染色、免疫组织化学和 Von Kossa 染色。第 2 阶段检查了年轻（急性 DVT 后≤ 1 年）和成熟（≥10 年）标本，以评估内皮功能的演变。使用四种生物标志物的抗体来检查新血管和再通通道（RC）内皮细胞 lining 的特定功能。
第 1 阶段：标本显示 80-90%的 I 型胶原、10-20%的 III 型胶原和营养不良性钙化。新血管和 RC 彼此靠近。血栓和平滑肌细胞不存在，但存在白细胞。第 2 阶段：VEGFR2 受体摄取在新血管中比 RC 更丰富，在年轻标本中更为明显。在年轻标本中观察到更多的新生非通道细胞。CD-31 在年轻和成熟标本中相似。TIE-2 和血管性血友病因子抗体在成熟标本中的摄取量更大。
引起慢性血栓后静脉阻塞的组织主要是 I 型胶原。新生血管形成和再通发生在密切相关的位置。新生血管形成和血管生成的生物标志物（VEGFR2）在年轻标本中更为明显，而 TIE-2 作为一种稳定的生物标志物和 vWF 在成熟标本中更为常见。
