StatusThe thesis was presented on the 24 November, 2021
Approved by NCAA on the 1 March, 2022
Abstract– 2.19 Mb / in romanian
ThesisCZU [611.147.33+611.147.38] (043.2)
11.68 Mb /
The structure of the thesis: The thesis includes 149 pages with the following structure: introduction, five chapters, general conclusions, practical recommendation and bibliography that comprises 248 references. The thesis contains 62 figures, 14 tables, 9 annexes and 118 pages of the basic text. The obtained results were published in 14 scientific works.
The purpose of the study: To study the morphology and individual anatomical variability of the saphenous veins under normal conditions and in case of the varicose disease.
The objectives of the study: To study the morphology and topography of the components of the superficial venous system of the lower limb (origin, path, tributaries, anastomoses, junctions, diameters, etc.) under normal conditions and individual variability. To establish the structural and topographical interrelations of the components of the superficial venous system of the lower limb with the trunks and rami of the cutaneous nerves of the region. To evaluate the vascular density and the density of nerve fibers in the non-varicous saphenous vein wall in patients with atherosclerosis and associated diabetes mellitus. To determine the histopathological modifications of the varicose saphenous veins in correlation with the evolutionary stages of the chronic venous disease. To determine the role of the endothelium and smooth muscle cells in the pathogenesis of varicose veins by applying anti-CD34 and anti-αSMA immunohistochemical markers.
The scientific novelty and originality: The individual anatomical variability of the saphenous veins at the origin, on the trajectory and at their inflow in the deep venous system was evaluated. Although, the venous variants described in this study broadly confirm the previous descriptions, there are also some differences between our own observations and those described in the literature, which indisputably complement the existing information. For example, the duplicity and the absence of the dorsal venous arch of foot were established, variants that were not previously mentioned in the literature. Studying the histological structure of the venous wall, the density of the vasa vasorum and nervi vasorum was determined both at the level of the adventitia and of the media. Changes in the structure of the venous wall at different stages of the varicose disease were analyzed, especially the endothelial, matrix and smooth muscle components, the main role being assigned to the vascular smooth muscle cells.
The scientific solved problem: The obtained results contribute to the scientific substantiation of the high variability of the superficial venous system of the lower limbs, as well as to the understanding of the etiopathogenesis of the varicose disease, the role of the endothelium, the extracellular matrix and of the vascular smooth myocytes in venous wall resistance.
The theoretical significance and applicative value of the work: The present study comes to argue and complete the existing anatomical knowledge with new information about the morphology and individual variability of the superficial venous system of the lower limbs so necessary for the vascular and cardiac surgeons. Modifications of the components of the three layers of the venous wall support the primary role of the vascular smooth myocytes in the pathogenesis of the varicose disease.
The implementation of the scientific results: The obtained results on the individual anatomical variability of the saphenous veins, morphology of varicose and non-varicose veins, are implemented in the scientific and teaching processes at the Department of anatomy and clinical anatomy, and at the Department of histology, cytology and embryology of “Nicolae Testemitanu” SUMPh.