The venous valve in the aged

Saphir, Otto; Lev, Maurice

doi:10.1016/0002-8703(52)90130-0

Cited by 20 publications

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“…Other data were based on autopsy studies including smaller numbers of valves and a narrower age range. 14,26 Valves in our study were found to increase in thickness with age, although the increase was modest and not consistent over all age groups. The results of other studies support our findings.…”

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confidence: 55%

“…Histology studies also found increasing thickness of valves with age in renal, 14 great saphenous, 27 and femoral veins. 26 Thickening of the valve cusps with age was described to be due to increased collagen deposition and a thickened lamina elastica. The latter leads to elasticity loss of the valves.…”

Section: Discussionmentioning

confidence: 99%

“…The latter leads to elasticity loss of the valves. 26 In a study comparing venous compliance in the calf between young (median age, 22 years) and older volunteers (median age, 64 years), a 45% reduction in compliance was found in older versus younger participants. 8 As the efficiency of the calf muscle pump decreases with age, 28 venous flow can become further impaired.…”

Section: Discussionmentioning

confidence: 99%

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The Effect of Aging on Venous Valves

Langevelde

Šrámek

Rosendaal

2010

ATVB

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Objective-Age is the strongest risk factor for venous thrombosis. Vessel wall changes such as thickening of venous valves may be one of the contributing mechanisms. We determined thickness and function of venous valves in the popliteal vein with ultrasound in 77 healthy individuals. Methods and Results-The study included 6 age groups ranging from 20 to 80 years old. Thickness of the valves was compared between age groups. Valve closure time was assessed as an indicator for valve function. In 69 of 77 participants, valve parameters could be measured. We found an increasing thickness of the valves with age, with a mean thickness of 0. Key Words: aging Ⅲ ultrasonic diagnosis Ⅲ venous thrombosis Ⅲ venous valves D eep-vein thrombosis (DVT) of the lower extremities is a disease with an annual incidence of 1 to 2 per 1000. 1,2 Risk factors for venous thrombosis can be divided into acquired and genetic risk factors. Among genetic risk factors are deficiencies of antithrombin, protein C, and protein S, which give a high risk for DVT but have low societal impact because of their low prevalence (Ͻ0.1%). 3 Risk factors such as the prothrombin 20210A and Factor V Leiden mutations are highly prevalent (3% to 8%) and are of intermediate strength. 4,5 Surgery and use of oral contraceptives are examples of highly prevalent acquired risk factors.Aging is the strongest risk factor for venous thrombosis. In people under the age of 40, the incidence is less than 1 per 10 000. 6 However, the incidence of venous thrombosis increases to 1 per 100 per year in elderly over the age of 75. 7 It is not clear why age is such an important risk factor. Explanations such as a decrease in mobility, an increase in prevalence of diseases with a high thrombotic risk (ie, malignancies, hip fractures), reduced venous compliance in the calf, and damaged venous valves have been suggested. 8 -10 Venous valves function to ensure that a proper inflow of blood reaches the heart during various cardiovascular adjustments. They can be regarded as flow modifiers that act and react constantly. 11,12 Venous valves are bicuspid and are positioned in a valve sinus, which is a local widening of the venous wall. The area between a valve leaflet and the vessel wall is called the valve pocket and is regarded as the place where thrombi originate. Low shear stress areas and stasis of blood flow predispose to thrombus formation. In the deepest part of the valve pockets, fluid circulates with very low velocities, creating a low shear field, thus allowing red cells to aggregate. Stagnation of blood leads to hypoxia, which subsequently causes endothelial damage. In case of nonpulsatile flow, a canine study showed that a thrombus was formed on a valve cusp after only 2 hours. 13 Age-related changes of the venous wall and valves have been described in renal veins. 14 Muscle fibers in the vessel wall atrophy with increasing age, whereas elastic fiber bundles hypertrophy. With respect to the valves, a gradual thickening with age was seen as a result of an increased number of ...

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confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Effect of Aging on Venous Valves

Langevelde

Šrámek

Rosendaal

2010

ATVB

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“…Saphir & Lev, 1952b;Van Langevelde et al, 2010), and it is consistent with the readiness of venous thrombi to embolise. However, though it is consistent with them, some might reserve judgment as to whether it accounts fully and explicitly for (1) the high density of the fibrin around the Kopfteil and (2) the Lines of Zahn.…”

Section: Accounting For Virchow's Real Triadsupporting

confidence: 77%

Aetiology of Deep Venous Thrombosis - Implications for Prophylaxis

Agutter¹,

Malone²

2012

Pathophysiology and Clinical Aspects of Venous Thromboembolism in Neonates, Renal Disease and Cancer Patients

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“…Age‐related changes of venous valves have been described in several ex vivo studies and in one in vivo study. The ex vivo studies demonstrated a thickening of the valves with age in renal and in femoral veins . The thickening of the valves in these studies was shown to be the result of atrophy of muscle fibers, hypertrophy of elastic fibers, and an increased number of collagen fiber bundles.…”

Section: Introductionmentioning

confidence: 78%

Aging of the venous valves as a new risk factor for venous thrombosis in the elderly: the BATAVIA study

Karasu

Šrámek

Rosendaal

et al. 2018

Journal of Thrombosis and Haemostasis

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To cite this article: Karasu A, Sr amek A, Rosendaal FR, van der Geest RJ, van Hylckama Vlieg A. Aging of the venous valves as a new risk factor for venous thrombosis in the elderly: the BATAVIA study. J Thromb Haemost 2018; 16: 96-103. Essentials• Risk of venous thrombosis (VT) related to valve thickness and valvular reflux in unknown.• Venous valves and reflux were measured by ultrasonography in cases and controls aged 70+.• Risk of VT was associated with increased valve thickness and valvular reflux >1second.• Thickening of valves is a generic process: there was no difference between right and left legs.Summary. Background: Increasing age is the strongest risk factor for venous thrombosis (VT). Increasing age has been related to a thickening of the venous valves and a decreased valvular function. The association between valve thickness and the risk of VT is not known. Objectives: To assess the association between increased valve thickness and valve closure time (VCT) and the risk of VT. Methods: Analyses were performed in the BATAVIA study, including 70 cases aged 70 + with a first VT and 96 controls. We performed an ultrasound examination of the valves in the popliteal veins. The valves were imaged with a 9 MHz linear probe using B-mode ultrasonography. VCT was measured as an indicator for valve function using an automatic inflatable cuff. To estimate the risk of VT, valve thickness was dichotomized at the 90th percentile as measured in controls and VCT was dichotomized at 1 s.

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The venous valve in the aged

Cited by 20 publications

References 0 publications

The Effect of Aging on Venous Valves

The Effect of Aging on Venous Valves

Aetiology of Deep Venous Thrombosis - Implications for Prophylaxis

Aging of the venous valves as a new risk factor for venous thrombosis in the elderly: the BATAVIA study

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