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Vol. 26, Art. 3 (pp. 39-67)    |    2025       

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Endothelial glycocalix in varicose veins of the lower extremities pathogenesis

Korsakova N.E.1, Golovina O.G.1, Silina N.N.1, Bessmeltsev S.S.1,2

1Russian Research Institute of Hematology and Transfusiology, St. Petersburg, Russia
2Federal State Budgetary Institution of Higher Education
«North-Western State Medical University named after I.I. Mechnikov»
of the Ministry of Health of the Russian Federation

Brief summary

Varicose veins of the lower extremities are the most common manifestation of chronic venous diseases, which, with progression, contribute to the development of chronic venous insufficiency and venous thromboembolic complications. The primary link in the development of varicose veins is changes in macrocirculatory hemodynamics, which are accompanied by increasing venous hypertension in the superficial veins, contributing to pathological changes in the vein wall and venous valves. The endothelium is a monolayer of cells forming the inner lining of blood vessels, and has multiple regulatory effects on the structural and functional features of blood vessels. The luminal surface of endothelial cells is represented by a glycocalyx, a carbohydrate-rich supramembrane complex that actively participates in endothelial functions. The endothelial glycocalyx provides both maintenance of the physiological state of the endothelium and stimulation of thromboinflammation in case of impaired functionality. The aim of the study was to validate the role of endothelial glycocalyx in the development of varicose veins of the lower extremities. Materials and methods. The materials used were russian and foreign scientific publications found as a result of a search in scientific electronic libraries. The main research method was to summarize the available literature data on the pathophysiology and pathogenesis of chronic venous diseases, in particular, varicose veins, and the role of structural and functional features of the endothelium and endothelial glycocalyx in this pathology. Results. An analysis of the available publications indicates that due to the fact that the endothelium and endothelial glycocalyx of the vascular wall are the first to be affected by pathological blood flow, they mediate the subsequent development of structural and functional disorders of the venous wall and valves during varicose transformation. Conclusion. Endothelial glycocalyx disorder and endothelial dysfunction play a crucial role in the development and progression of varicose veins of the lower extremities.


Key words

chronic venous diseases; endothelial dysfunction; endothelium; glycocalyx; thromboinflammation; varicose veins of lower extremities

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