Venous Muscle Pump Improvement by Low Compression Elastic Stockings

1986 ◽  
Vol 1 (2) ◽  
pp. 97-103 ◽  
Author(s):  
Jan Struckmann ◽  
Søren Jesper Christensen ◽  
Axel Lendorf ◽  
Frits Mathiesen
Keyword(s):  
Venous Return ◽  
Varicose Veins ◽  
Return Time ◽  
Physiological Effect ◽  
Compression Stocking ◽  
Subjective Improvement ◽  
Muscle Pump ◽  
Before And After ◽  
Elastic Stockings ◽  
Primary Varicose Veins

The physiological effect of a graduated low compression stocking T.E.D.(R) (Kendall Co.) was evaluated by plethysmographic musculo-venous pump determination in 22 patients with primary varicose veins. A hip length T.E.D.(R) stocking was worn for a 6-week period. Efficiency of the musculo-venous pump was determined before and after treatment and a significant increase in venous return time (RT) and expelled volume (EV) was demonstrated. This was accompanied by subjective improvement. The pressure exerted by the stockings was measured in 20 legs by the Borgnis and Van den Berg method, and the pressure was in all cases below 15 mmHg. Effect of such low compression has not previously been documented for expelled volume in patients with varicose veins.

Venous Muscle Pump Function following Reconstructive Arterial Surgery

1988 ◽  
Vol 3 (3) ◽  
pp. 169-173
Author(s):  
Jan R. Struckmann
Keyword(s):  
Clinical Evidence ◽  
Venous Return ◽  
Clinical Results ◽  
Return Time ◽  
Venous Disease ◽  
Arterial Reconstruction ◽  
Pump Function ◽  
Muscle Pump ◽  
Before And After ◽  
Reconstructive Arterial Surgery

The changes that occur in the leg venous muscle pump function were studied before and after proximal arterial reconstruction in 25 patients with claudication but without rest pain or clinical evidence of venous disease. There was found a significant increase in the distal blood pressure index corresponding to excellent clinical results. The venous muscle pump was affected such that venous return time, RT, decreased significantly ( P < 0.02) but expelled volume, EV, was not significantly affected. It is concluded that these findings may be explained by a postoperative increase in exercise bloodflow and that alterations in RT not only can be caused by changes in venous reflux but also by alterations in arterial input to the leg. The muscle pump capability to pump blood towards the heart was unaffected (EV constant) and it can thus not be incriminated for the postreconstructive oedema often found after arterial surgery. When evaluating isolated RT changes it is necessary to consider whether the arterial input to the pump is constant.

Standard Stripping versus Long Saphenous Vein-Saving Surgery for Primary Varicose Veins: A Prospective, Randomized Study with the Patients as Their Own Controls

1996 ◽  
Vol 11 (2) ◽  
pp. 45-49 ◽  
Author(s):  
M. Campanello ◽  
J. Hammarsten ◽  
C. Forsberg ◽  
P. Bernland ◽  
O. Henrikson ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Venous Return ◽  
Varicose Veins ◽  
Return Time ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Long Saphenous Vein ◽  
Primary Varicose Veins ◽  
Postoperative Discomfort

Objective: To compare the postoperative discomfort and long-term outcome following standard stripping and atter long saphenous vein-saving surgery. Design: Prospective, randomized case-control study with patients serving as their own controls. Setting: Department of Surgery, County Hospital, Varberg, Sweden. Patients: Eighteen patients with bilateral primary varicose veins. Interventions: The patients were randomized prospectively to stripping or long saphenous vein-saving surgery. The leg causing most discomfort was operated on first. The other leg was operated on using the alternative method. Main outcome measures: Postoperative discomfort was assessed after an interview with the patient. Long-term outcome was determined by clinical assessment and Plethysmographic venous return time. Results: After 4 years the legs subjected to long saphenous vein-saving surgery yielded equal clinical results and had as great a prolongation of the plethysmographic venous return time as legs operated on using standard stripping. More patients reported greater discomfort following stripping than after vein-saving surgery. The saved long saphenous vein in all legs operated on was patent, compressible, non-sclerotic and free of intraluminal echoes. Conclusion: The long-term results of long saphenous vein-saving surgery are as good as standard stripping, provided that incompetent perforators are throughly mapped preoperatively and ligated at surgery. Long saphenous vein-saving surgery causes less subjective postoperative discomfort than standard stripping. The saved long saphenous vein can probably be used for future arterial reconstruction.

A Study of the Mechanisms by Which Haemodynamic Function Improves following Long Saphenous Vein-Saving Surgery

1996 ◽  
Vol 11 (3) ◽  
pp. 102-105 ◽  
Author(s):  
J. Hammarsten ◽  
P. Bernland ◽  
M. Campanello ◽  
M. Falkenberg ◽  
O. Henrikson ◽  
...  
Keyword(s):  
Physical Examination ◽  
Saphenous Vein ◽  
Strain Gauge ◽  
Venous Return ◽  
Varicose Veins ◽  
Return Time ◽  
Strain Gauge Plethysmography ◽  
Long Saphenous Vein ◽  
Primary Varicose Veins ◽  
Vein Diameter

Objective: To study the mechanisms by which haemodynamic function improves following long saphenous vein-saving surgery. Design: Cohort study. Patients: Twenty patients, 14 women and six men, with primary varicose veins. Interventions: Varicose vein surgery by the long saphenous vein-saving technique. Main outcome measures: Preoperative investigation by physical examination, strain-gauge plethysmography, phlebography and measurements of the long saphenous vein diameter at four different locations using high-resolution, real-time ultrasound. Three months following vein-saving surgery, the patients were reassessed with physical examination, strain-gauge plethysmography and measurements of the long saphenous vein diameter. Results: All patients but one showed excellent or good results following surgery. The preoperative diameter of the long saphenous vein was reduced by 40% at four different levels in the operated legs ( p<0.01). The venous return time of the same legs increased 2.4 times ( p<0.001). The decrease of the long saphenous vein diameter correlated positively with the increase in venous return time (t-50), ( r=0.50, p=0.04). Conclusion: The results suggest that the development of incompetent perforators is an early major event in the formation of primary varicose veins. The results also suggest that the long saphenous vein valvular incompetence in varicose veins is attributable to venous wall dilatation rather than degeneration of the valves. The results support the hypothesis that the improvement in haemodynamic function following long saphenous vein-saving surgery is due, at least partly, to a reduction of the long saphenous vein diameter, which in turn tends to restore valvular competence.

Interface Pressure under Elastic Stockings with Compression Pads during Posture Changes and Exercise

1999 ◽  
Vol 14 (2) ◽  
pp. 71-76 ◽  
Author(s):  
M. Hirai
Keyword(s):  
Strain Gauge ◽  
Pressure Measurement ◽  
Varicose Veins ◽  
Pressure Measurements ◽  
Interface Pressure ◽  
Elastic Materials ◽  
Muscle Pump ◽  
Strain Gauge Plethysmography ◽  
Elastic Stockings ◽  
College Of Nursing

Objective: To quantify the influence of posture and exercise on the interface pressure obtained under elastic stockings with compression pads. Design: Interface pressure measurement and plethysmographic evaluation of elastic stockings with and without compression pads. Setting: Department of Surgery, Aichi Prefectural College of Nursing, Nagoya, Japan. Main outcome measures: Pressure measurements in 24 volunteers were obtained beneath elastic stockings, elastic bandages and short-stretch bandages during supine resting, standing, tip-toe exercise and walking, and the effect of elastic stockings on the muscle pump of the leg was evaluated by strain-gauge plethysmography in 40 limbs with varicose veins. Results: Without compression pads, only short-stretch bandages showed a significant increase in pressure during standing and exercise. When pads were used, however, elastic stockings and bandages also showed a significant increase. With pads, significant improvement in the expelled volume during exercise was observed by strain-gauge plethysmography. Conclusions: Interface pressure under elastic materials during posture and exercise is similar to that under short-stretch bandages when compression pads are used, and pads effectively augment the muscle pump.

The Elastic Properties of the Human Great Saphenous Vein in Relation to Primary Varicose Veins

1974 ◽  
Vol 52 (2) ◽  
pp. 153-157 ◽  
Author(s):  
J. Kenneth Booking ◽  
Margot R. Roach
Keyword(s):  
Elastic Properties ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Simultaneous Measurements ◽  
Saphenous Veins ◽  
Before And After ◽  
Laplace’S Law ◽  
Primary Varicose Veins ◽  
Laplace's Law

Simultaneous measurements of pressure and volume were made on nine great saphenous veins obtained at autopsies and nine great saphenous veins that were stripped during surgery from patients with primary varicose veins. Similar measurements were also made on six great saphenous veins obtained at autopsy before and after they were held at 100 cm H2O for 4 h. Circumferential tensions were calculated from Laplace's law (tension = pressure × radius).The great saphenous veins from patients with primary varicose veins had significantly greater radii and were more distensible than the normal great saphenous veins. After being held at 100 cm H2O for 4 h, the normal great saphenous veins became less distensible and their radii at distending pressures increased.Due to the great difference in radii, the circumferential tension on a great saphenous vein from a patient with primary varicose veins is much greater than that on a normal great saphenous vein at the same distending pressure. However, the physical stresses exerted on the great saphenous veins during the stripping operations may influence our results in some unknown way.

scholarly journals Modification of Primary Avalvular Varicose Anomaly after endovenous radiofrequency ablation

Phlebologie ◽  
2019 ◽  
Vol 48 (06) ◽  
pp. 373-376
Author(s):  
Daniele Bissacco ◽  
Silvia Stegher ◽  
Fabio Massimo Calliari ◽  
Marco Piercarlo Viani
Keyword(s):  
Radiofrequency Ablation ◽  
Saphenous Vein ◽  
Ultrasound Examination ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Invasive Procedure ◽  
Before And After ◽  
Primary Varicose Veins ◽  
Partial Thrombosis

AbstractPrimary avalvular varicose anomaly (PAVA) is a new medical concept defined as primary varicose veins resembling neovascularized tissue on ultrasound examination. PAVAs could be misdiagnosed as recurrence at the saphenofemoral or saphenopopliteal junction, but no studies have yet examined their role before and after venous invasive procedure. In this report, we describe a case of PAVA in a 39-year-old man with symptomatic varicose veins and great saphenous vein truncal incompetence. Six months after radiofrequency ablation of the great saphenous vein, duplex ultrasound revealed complete occlusion of great saphenous vein and partial thrombosis of the still incompetent PAVA.

Ambulatory Venous Pressure and Leg Volume Measurements before and after Surgery for Primary Varicose Veins

1997 ◽  
Vol 12 (3) ◽  
pp. 86-90 ◽  
Author(s):  
M. Vayssairat ◽  
K. Chakkour ◽  
P. Gouny ◽  
A. Taccoen ◽  
C. Cheynel ◽  
...  
Keyword(s):  
Varicose Veins ◽  
Venous Pressure ◽  
Early Morning ◽  
University Hospital ◽  
Venous Surgery ◽  
Before And After ◽  
Volume Measurements ◽  
Primary Varicose Veins ◽  
Venous Function ◽  
The Times

Objective: To compare clinical disability, ambulatory venous pressure (AVP) and leg volume before and after venous surgery, and to relate the changes to those observed after one night preoperative in-hospital rest. Design: Prospective study. Setting: Department of Vascular Surgery, University Hospital, Paris, France. Subjects: Nineteen patients with primary varicose veins and mild chronic venous insufficiency (CVI), scheduled for venous surgery. Main outcome measures: Clinical disability recorded by the analogue scale method, and leg volume and AVP measurements. These evaluations were repeated three times: on the day before surgery, in the afternoon; in the early morning on the day of surgery; and 2 months after surgery, in the afternoon. Results: Varicose vein surgery improved disability ( p = 0.001) and two AVP parameters: recovery time (RT, p = 0.0049) and the calf muscle pump index (CMPI), which rose by 345% (95% confidence intervals: 29, 659). Preoperative supine rest for one night improved disability ( p = 0.0016) and reduced leg volume ( p = 0.0002). The improvements induced by surgery correlated with the changes induced by rest, for disability ( p = 0.016), RT ( p = 0.006) and CMPI ( p = 0.033). Conclusion: Surgery improves venous function in patients with primary varicose veins. AVP remains a standard method of evaluating CVI. Combined with volumetry, it allows sensitive comparisons between different treatments. Because venous function varies greatly with daily activity, it is imperative to standardize the times at which venous function is evaluated.

Comparison of Three Exercises for Evaluation of the Calf Muscle Pump

1995 ◽  
Vol 10 (1) ◽  
pp. 23-27 ◽  
Author(s):  
S. Ohgi ◽  
K. Tanaka ◽  
T. Maeda ◽  
Y. Kanaoka ◽  
M. Ikebuchi ◽  
...  
Keyword(s):  
Venous Insufficiency ◽  
Varicose Veins ◽  
Venous Pressure ◽  
Calf Muscle ◽  
Venous Disease ◽  
Muscle Pump ◽  
Vein Thrombosis ◽  
Calf Muscle Pump ◽  
Primary Varicose Veins ◽  
Deep Vein

Objective: To evaluate accurately the calf muscle pump in patients with venous insufficiency using foot vein pressure measurements during three different exercises. Design: Prospective study in three groups, comparing patients with venous disease with controls. Setting: Second Department of Surgery, Tottori University Faculty of Medicine. Patients: Twenty normal legs, 29 legs previously affected by deep vein thrombosis and 36 legs with primary varicose veins. Main outcome measures: The foot vein pressure was measured during ankle dorsiflexions, knee-bending and walking on the spot at 40 paces per minute during which minimum ambulatory venous pressure (AVP) and venous refilling time (VRT) were assessed. Results: The three groups differed significantly from each other in AVP and VRT after dorsiflexion and in AVP during walking on the spot, but not after knee-bending. Conclusion: Dorsiflexion is the most useful exercise distinguishing various severities of venous insufficiency, but walking on the spot is more useful for accurately evaluating the calf muscle pump.

Ambulatory Strain Gauge Plethysmography: Correlation to Symptoms and Skin Changes in Patients with Venous Insufficiency

1987 ◽  
Vol 2 (2) ◽  
pp. 75-80 ◽  
Author(s):  
Jan Reinhold Struckmann
Keyword(s):  
Strain Gauge ◽  
Predictive Value ◽  
Venous Insufficiency ◽  
Venous Return ◽  
Return Time ◽  
Present Material ◽  
Skin Changes ◽  
Muscle Pump ◽  
Strain Gauge Plethysmography ◽  
Normal Controls

Ambulatory strain gauge plethysmography (ASPG) is one of several different methods applicable in the quantification of venous insufficiency. The present material demonstrates a correlation between this muscle pump quantification and symptoms in patients with venous insufficiency. Patients with few symptoms differed in their muscle pump values from those with many symptoms. A correlation was demonstrated between skin changes and the measured degree of pump dysfunction. In 81 patients and eight normal controls, the diagnostic validity of ambulatory strain gauge plethysmography was calculated. The predictive value of a negative test (PVneg) for RT (venous return time) was 0.94 and for EV (expelled volume) 0.75. Correspondingly the predictive value of a positive test (PVpos.) was found to be 1.0 for RT and 1.0 for EV.

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