Characterization of a porcine model of chronic superficial varicose veins

• Published in: Journal of vascular surgery 2009-06, Vol.49 (6), p.1554-1561
• Main Authors: Jones, Gregory T., PhD, Grant, Mark W., MBBS, Thomson, Ian A., MBChB, FRACS, Hill, B. Geraldine, BSc, DMU, van Rij, André M., MD, FRACS
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; Arteriovenous Shunt, Surgical; Biological and medical sciences; Blood Flow Velocity; Chronic Disease; Corrosion Casting; Dilatation, Pathologic; Disease Models, Animal; Disease Progression; Emergency and intensive care: renal failure. Dialysis management; Femoral Artery - surgery; Femoral Vein - surgery; Intensive care medicine; Lower Extremity - blood supply; Medical sciences; Regional Blood Flow; Saphenous Vein - pathology; Saphenous Vein - physiopathology; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Swine; Time Factors; Ultrasonography, Doppler, Color; Varicose Veins - diagnostic imaging; Varicose Veins - pathology; Varicose Veins - physiopathology; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; Venous Insufficiency - diagnostic imaging; Venous Insufficiency - pathology; Venous Insufficiency - physiopathology; Venous Pressure
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2009.01.070

Objective Previous animal models of venous disease, while inducing venous hypertension and valvular insufficiency, do not produce superficial varicose veins. In this study, we aimed to develop and characterize a pig-based model of superficial varicose veins. Methods Right femoral arteriovenous fistulae (AVF) were surgically fashioned in young adult pigs. Animals were examined at postoperative times up to 15 weeks to determine the development of varicose veins and measurement of both blood pressure and flow velocities within the superficial thigh veins. Histology and vascular corrosion casts were used to characterize the resulting structural venous alterations. Porcine pathophysiological features were compared with those of human primary superficial varicose veins. Results Gross superficial varicosities developed over the ipsilateral medial thigh region after an initial lag period of 1-2 weeks. Veins demonstrated retrograde filling with valvular incompetence, and a moderate, non-pulsatile, venous hypertension, which was altered by changes in posture and Valsalva. Venous blood flow velocities were elevated to 15-30 cm/s in varicose veins. Structurally, pig varicose veins were enlarged, tortuous, had valvular degeneration, and regions of focal medial atrophy with or without overlying intimal thickening. Conclusions The superficial varicose veins, which developed within this model, have a pathophysiology that is consistent with that observed in humans. The porcine femoral AVF model is proposed as a suitable experimental model to evaluate the pathobiology of superficial venous disease. It may also be suitable for the evaluation of treatment interventions including drug therapy.