RESUMEN
AIM: The role of SMC apoptosis and proliferation was correlated to the amount of fibrillin and alfa-smooth muscle actin of primary varicose veins. METHODS: Twenty varicose vein specimens were atraumatically harvested from 20 women undergoing lower extremity primary varicose vein excision. The patients were divided into groups according to age (<50 years, >50 years) and the presence of leg edema (CEAP, class 2 or 3). The surface density of fibrillin-1 fibers (Sv([Fbn-1])), the volume density of smooth muscle cells: (Vv([SMC])), the number of proliferating and apoptotic cells per area. Quantitative data comparisons between class and age groups were performed. RESULTS: The median value of Vv([SMC]) was 16% greater and the Sv([Fbn-1]) was 35% greater in the intima vein sections from patients up to 50y compared to >50y. Apoptosis was found more frequent in veins sections from varicose women >50y. In the media layer, Sv([Fbn-1]) in veins from patients up to 50y was more important, and women with >50y had also more cells in apoptosis. Vv([SMC]) from women without edema (CEAP-Class 2) was 28% greater in the intima and apoptotic cells were more prominent in the intima of women with edema (CEAP-Class 2). In the media layer, Sv([Fbn-1]) was 12,5% greater in veins from women without edema and apoptosis was more detected in the veins from patients with edema. CONCLUSION: Age of the patient may affect the remodeling of varicose veins and SMC quantity in the media layer was found decreased in patients with edema.