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Varicose Veins: Venous Wall Changes, Inflammation, and Matrix Metalloproteinases

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Inflammatory Response in Cardiovascular Surgery

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Abstract

Varicose veins are superficial vessels that are abnormally twisted, lengthened, or dilated, and they are usually caused by inefficient or defective valves within the vein. Varicose veins are part of the spectrum of chronic venous diseases (CVDs), which affect millions of people throughout Western populations [1]. There is significant evidence in the literature that wall dysfunction consisting of alterations in the endothelium and smooth muscle cells (SMCs) are a principal cause for varicose veins [2]. In addition, matrix metalloproteinases (MMPs) are present in varicose veins and can be found in the endothelium, smooth muscle, and adventitial layers of the vein wall [3]. However, it is unclear whether the presence of MMPs is a result of chronic inflammation and venous wall remodeling or whether MMPs actually functional in veins, causing biochemical changes in the venous wall, leading to early dilation and chronic irreversible changes typified by varicose veins [2]. Furthermore, the role of venous wall dysfunction appears to precede valve dysfunction, is linked to MMPs [2], and is tightly regulated by hypoxia inducible factor.

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Authors and Affiliations

  1. Division of Vascular and Endovascular Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Joseph D. Raffetto MD, MS, FACS, FSVM

  2. Department of Surgery, 112, VA Boston Healthcare System, 1400 VFW Parkway, West Roxbury, MA, 02132, USA

    Joseph D. Raffetto MD, MS, FACS, FSVM

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  1. Joseph D. Raffetto MD, MS, FACS, FSVM
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Correspondence to Joseph D. Raffetto MD, MS, FACS, FSVM .

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Editors and Affiliations

  1. University Nove de Julho, Melo Alves 685, São Paulo, 01417-010, São Paulo, Brazil

    Edmo Atique Gabriel

  2. Pontifícia Universidade Católica de Camp, Rodovia D. Pedro I, km 136, São Paulo, 13086-900, São Paulo, Brazil

    Sthefano Atique Gabriel

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Raffetto, J.D. (2013). Varicose Veins: Venous Wall Changes, Inflammation, and Matrix Metalloproteinases. In: Gabriel, E., Gabriel, S. (eds) Inflammatory Response in Cardiovascular Surgery. Springer, London. https://doi.org/10.1007/978-1-4471-4429-8_22

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  • DOI: https://doi.org/10.1007/978-1-4471-4429-8_22

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4428-1

  • Online ISBN: 978-1-4471-4429-8

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