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Histology of saphenous veins after treatment with the ClariVein® device – an ex‐vivo experiment
Author(s) -
Kendler Michael,
Averbeck Marco,
Simon Jan C.,
Ziemer Mirjana
Publication year - 2013
Publication title -
jddg: journal der deutschen dermatologischen gesellschaft
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 60
eISSN - 1610-0387
pISSN - 1610-0379
DOI - 10.1111/ddg.12022
Subject(s) - medicine , ex vivo , catheter , adventitia , varicose veins , sclerotherapy , cd31 , vein , immunohistochemistry , great saphenous vein , endothelium , surgery , pathology , in vivo , microbiology and biotechnology , biology
Summary Background Endovenous treatment modalities are used increasingly to treat varicose veins. The ClariVein® catheter is a new endoluminal mechanico‐chemical obliteration technique which can be used without tumescent anesthesia. It is still unclear what changes the mechanical tip of the catheter has on the walls of the vein. Patients and methods Five great saphenous vein specimens were obtained atraumatically by crossectomy. Then the veins were treated ex vivo with the ClariVein® catheter without sclerotherapy. The activated catheter rotating tip (3 500 U/min) was steadily withdrawn at 1–2 mm per second. Subsequently, histological and immunohistochemical investigations of treated (cv) and untreated specimens (plain) were performed. A 4‐point score was calculated to compare the results. Results The mechanical part of the catheter caused a subtle incomplete destruction of the endothelium (endothelium cv: 2.2 vs. plain: 1, p = 0.04). Changes in the media or adventitia were not seen. Immunohistochemical presentation of the endothelium of the intima was demonstrated with antibodies against CD31 (cv: 3.4 vs. plain: 2.8), CD34 (cv: 3.8 vs. plain: 3.2) and factor VIII (cv: 2.2 vs. plain: 1, p = 0,004). Conclusions The mechanical part of the ClariVein® catheter caused a subtle incomplete destruction of endothelium, which was confirmed histologically and immunohistochemically. The reduced expression of factor VIII in the treated vein could be caused by the release of preformed factor VIII granules due to the minimal mechanical irritation.