Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2023; 11(35): 8404-8410
Published online Dec 16, 2023. doi: 10.12998/wjcc.v11.i35.8404
Phlebosclerosis: An overlooked complication of varicose veins that affects clinical outcome: A case report
Shi-Yan Ren, Song-Yi Qian, Rong-Ding Gao
Shi-Yan Ren, Rong-Ding Gao, Department of Laser and Vascular Surgery, Aviation General Hospital, Beijing 100012, China
Song-Yi Qian, Department of Cardiac Surgery, Zhongshan Hospital (Xiamen Branch), Fudan University, Xiamen 361015, Fujian Province, China
Author contributions: Ren SY drafted, submitted, and revised the manuscript; Ren SY and Gao RD performed the surgery and followed up with the patient; Qian SY and Gao RD analyzed and discussed the data in the manuscript; All authors have read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient and submitted.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shi-Yan Ren, MD, PhD, Chief Doctor, Surgeon, Department of Laser and Vascular Surgery, Aviation General Hospital, No. 3 Anwai Beiyuan, Chaoyang District, Beijing 100012, China. rens66@126.com
Received: September 24, 2023
Peer-review started: September 24, 2023
First decision: October 12, 2023
Revised: October 21, 2023
Accepted: October 27, 2023
Article in press: October 27, 2023
Published online: December 16, 2023
Abstract
BACKGROUND

Phlebosclerosis is a common age-related fibrotic degeneration of the venous wall. It is a disorder rather than a disease, which may cause venous dysfunction and even venous thrombosis. It is rarely reported in patients with varicose veins.

CASE SUMMARY

The present report describes the case of a 70-year-old man with varicose veins, vitiligo, and phlebosclerosis. Venous angiography revealed blood reflux in the superficial and deep veins. The patient underwent surgery to remove the saphenous veins. During the operation, a calcified vein resembling a wooden stick was found, which was surprisingly extracted from the thickened venous wall. A cross-section of this wooden stick-like vein revealed venous fibrosis and calcification, obvious thickening of the venous wall, extensive collagen deposition on the venous wall, hyaline degeneration, and venous sclerosis causing closure of the venous lumen.

CONCLUSION

This is probably the first report of a wooden stick-like structure being found in the venous wall in patients with varicose veins and venous ulcers. Phlebosclerosis can be observed in the late stage of varicose veins complicated by frequent infections and worse clinical outcomes. Therefore, it is important to be aware of this condition and address it rather than overlook it.

Keywords: Phlebosclerosis, Varicose vein, Phlebothrombosis, Thrombophlebitis, Calcification, Ossification of vein wall, Chronic venous disease, Case report

Core Tip: Phlebosclerosis is a common age-related fibrotic degeneration of the venous wall, which is overlooked and little-known. It may cause venous dysfunction and lead to venous thrombosis. We report a 70-year-old man with phlebosclerosis, varicose veins, and vitiligo. During surgery, a rod-like calcified vein was discovered. Surprisingly, a wooden stick-like structure was retrieved from this thickened venous wall. Phlebosclerosis often exists in the late stages of varicose veins and complicates the clinical outcome. Therefore, we should be aware of this condition rather than overlooking it.