Varicose veins: on the verge of discovering the cause?

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Varicose veins of the lower limbs are one of the most common and wide-spread pathology all around the world. What triggers the specific changes in a vein wall still remains unclear as well as what happens in the layers of the vein wall after the disease starts. The aim of the article is to analyze published data and results of researches on epidemiology, genetics, cellular and molecular mechanisms underlying varicose veins pathogenesis. It is now commonly accepted that vein wall changes in patients with varicose veins result from vein-specific inflammation. This process includes leukocytes adhesion to venous endothelium with their subsequent migration into the vein wall and surrounding tissues. Activated leukocytes express a number of molecules that lead to vein wall remodeling and dilation. Comprehensive assessment of the epidemiological data on the prevalence of varicose veins and risk factors, of the findings from genetic studies, of data on molecular-cell interactions as well as results of various surgical interventions in patients with varicose veins, shows that remodeling is a reversible process that can be stopped and reversed by different stimuli including some chemical substances. For the first time in the literature, the authors assume that varicose veins can be successfully cured pharmacologically with no surgical interventions needed.

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About the authors

Igor A. Zolotukhin

Pirogov Russian National Research Medical University; Institute of Experimental Medicine

ORCID iD: 0000-0002-6563-0471
SPIN-code: 3426-2981

Russian Federation, 1, Ostrovityanova street, Moscow, 117997; 8, Lavrentyeva prospect, Novosibirsk, 630090

MD, PhD, Professor

Olga Ya. Porembskaya

Institute of Chemical Biology and Fundamental Medicine SB RAS; North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
ORCID iD: 0000-0003-3537-7409
SPIN-code: 9775-1057

Russian Federation, 12, Academic Pavlov street, Saint-Petersburg, 197376; 41, Kirochnaya street, Saint-Petersburg, 191015


Mariya A. Smetanina

Institute of Experimental Medicine; Novosibirsk State University

ORCID iD: 0000-0001-6080-4615
SPIN-code: 6045-9880

Russian Federation, 8, Lavrentyeva prospect, Novosibirsk, 630090; 52, Krasny prospect, Novosibirsk, 630091


Aleksandr V. Sazhin

Pirogov Russian National Research Medical University

ORCID iD: 0000-0001-6188-6093
SPIN-code: 7064-6369

Russian Federation, 1, Ostrovityanova street, Moscow, 117997

MD, PhD, Professor

Maksim L. Filipenko

Institute of Experimental Medicine; Novosibirsk State University

ORCID iD: 0000-0002-8950-5368
SPIN-code: 4025-0533

Russian Federation, 8, Lavrentyeva prospect, Novosibirsk, 630090; 52, Krasny prospect, Novosibirsk, 630091


Aleksandr I. Kirienko

Pirogov Russian National Research Medical University

ORCID iD: 0000-0001-8792-1694
SPIN-code: 8319-5682

Russian Federation, 1, Ostrovityanova street, Moscow, 117997

MD, PhD, Professor


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Supplementary files

Supplementary Files Action
Fig. 1. Varicose veins in a 32-year-old patient with varicose veins. A typical version of the clinical picture (own observations)

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Fig. 2. Changes in the diameter of the large saphenous vein (1) at the place of its confluence with the femoral (2) in the patient before and after surgery (own observations)

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Fig. 3. Regression of varicose saphenous vein transformation in a 30-year-old patient with varicose veins 4 months after venous ligation in several places, without removing the affected vessels (own observations)

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