Marin M L, Gordon R E, Veith F J, Panetta T F, Sales C M, Wengerter K R
Division of Vascular Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY 10467.
Cardiovasc Surg. 1994 Feb;2(1):56-62.
This study describes the varied histologic features and ultrastructure of human saphenous veins obtained from patients undergoing infrainguinal arterial reconstruction. Portions of 30 remnant veins were fixed at arterial pressure (100 mmHg). Vein specimens were obtained from 13 men and 17 women, with a mean age of 70.2 years. Ten veins (33%) were from diabetic patients. Samples of fixed veins were prepared for light and electron microscopy. The luminal surface contained valves and redundant intimal folds at the site of ligated side branches. Microvalves were present at the orifices of several 1-mm vein tributaries. The endothelial cells lining the intima were often discontinuous and were aligned in a variable pattern. The thicknesses of the vein walls varied from 20 to 360 microns, with increased connective tissue matrix in the intima and medial layers of thick-walled veins. Some 10% of the veins demonstrated spindle cells in the intima; these cells had a smooth muscle cell phenotype and varied with respect to the degree of cellular differentiation. Regions of vein wall calcification were occasionally seen and were always present in association with a thickened vein intima. Variations in the structure of the saphenous vein from patients undergoing bypass surgery are common. The relationship between altered saphenous vein morphology and subsequent vein graft stenosis needs to be defined.
本研究描述了从接受腹股沟下动脉重建手术的患者获取的大隐静脉的各种组织学特征和超微结构。30条残余静脉的部分在动脉压（100 mmHg）下固定。静脉标本取自13名男性和17名女性，平均年龄为70.2岁。10条静脉（33%）来自糖尿病患者。将固定静脉的样本制备用于光学显微镜和电子显微镜检查。管腔表面在结扎侧支的部位有瓣膜和多余的内膜皱襞。在几条1毫米静脉分支的开口处存在微瓣膜。内膜的内皮细胞常常不连续，排列方式多变。静脉壁厚度从20到360微米不等，厚壁静脉的内膜和中膜结缔组织基质增加。约10%的静脉在内膜有梭形细胞；这些细胞具有平滑肌细胞表型，细胞分化程度各异。偶尔可见静脉壁钙化区域，且总是与增厚的静脉内膜相关。接受旁路手术患者的大隐静脉结构变化很常见。大隐静脉形态改变与随后的静脉移植物狭窄之间的关系有待明确。
