Microvascular Evaluation by Laser—Dopper Flowmetry of the Effects of Centellase in the Treatment of Severe Venous Hypertension and Leg Ulcers

1987 ◽  
Vol 2 (3) ◽  
pp. 189-195 ◽  
Author(s):  
G. Belcaro
Keyword(s):  
Venous Pressure ◽  
Venous Hypertension ◽  
Leg Ulcers ◽  
Vasomotor Response ◽  
Venous Ulceration ◽  
Doppler Flowmetry ◽  
Before And After ◽  
Venoactive Drugs ◽  
Positive Effect ◽  
Standard Techniques

A study of the microcirculation in patients with venous hyperterision and perimalleolar ulcers was used to evaluate the effects of medical treatment by Centellase 60. The evaluation of the resting flow and the observation of the venous response before and after treatment shows an interesting, positive effect of Centellase 60 in 25 patients with venous ulceration treated for 4 weeks. The decrease of the resting flow and the increased efficacy of the venous vasomotor response was both significant and associated with a significant decrease of the ulcerated areas. Laser-Doppler flowmetry was useful to demonstrate microcirculatory changes which were not revealed by standard techniques such as ambulatory venous pressure. It may be useful to reveal variations in venous hypertension produced by other treatments such as elastic compression or ‘venoactive’ drugs.

Wound Care for Venous Ulceration

2021 ◽  
Vol 38 (02) ◽  
pp. 194-201
Author(s):  
Sarah E. Schroeppel DeBacker ◽  
Julie C. Bulman ◽  
Jeffrey L. Weinstein
Keyword(s):  
Wound Care ◽  
Treatment Success ◽  
Scoring Systems ◽  
Venous Hypertension ◽  
Disease Classification ◽  
Venous Disease ◽  
Leg Ulcers ◽  
Venous Ulceration ◽  
Ultrasound Evaluation ◽  
Careful Clinical Examination

AbstractVenous leg ulcers (VLUs) affect as many as 20% of patients with advanced chronic venous insufficiency and are associated with significant morbidity and health care costs. VLUs are the most common cause of leg ulcers; however, other etiologies of lower extremity ulcerations should be investigated, most notably arterial insufficiency, to ensure appropriate therapy. Careful clinical examination, standardized documentation, and ultrasound evaluation are needed for diagnosis and treatment success. Reduction of edema and venous hypertension through compression therapy, local wound care, and treatment of venous reflux or obstruction is the foundation of therapy. As key providers in venous disease, interventional radiologists should be aware of current standardized disease classification and scoring systems as well as treatment and wound care guidelines for venous ulcers.

scholarly journals The Effect of Aqua-trainings are in Fresh Water in Patients with Hypertension on the Microcirculation

2020 ◽  
Vol 100 (6) ◽  
pp. 25-32
Keyword(s):  
Fresh Water ◽  
Laser Doppler Flowmetry ◽  
Warm Pool ◽  
T Test ◽  
Laser Doppler ◽  
Venous Stasis ◽  
Doppler Flowmetry ◽  
Before And After ◽  
Aquatic Training ◽  
Positive Effect

Walking in water (Aquatic Physiotherapy) is a simple, reproducible and affordable method. Warm pool water reduces peripheral vascular resistance. Purpose of the study was to assess the effect of dosed physical activity in a fresh water on the microcirculation of patients with arterial hypertension (AH) when applied externally. Materials and methods. The study included 14 subjects (7 men, 7 women) aged 18 to 70, with AH stage I. The patients were administered aqua training course in the form of walking in a fresh water for the 30 minutes duration, the course of treatment included 10 procedures, the water temperature in the pool was 30–32C. Before and after the end of the intervention, several parameters were monitored, including the assessment of microcirculation using laser Doppler flowmetry. Results: In patients receiving aqua training in a fresh water, there was a significant decrease of arterio-venular bypass grafting by 25.0%from the initial (Wilcoxon T-test = 310.0; p = 0.004) and an increase in the muscle component of microcirculation regulation (Wilcoxon T-test = 399.0; p <0.05), which indicates an improvement in microcirculation under the influence of aqua training. The optimal duration of training in fresh water was found to be equal to five days, after which the indicators characterizing microcirculation remain at the plateau level, without significantly changing. Significantly more often, the positive effect of aqua training was achieved in the group of patients with microcirculation disorders of the type of venous stasis (χ2 = 10.6; p <0.001). Conclusion. Laser Doppler flowmetry screening may be useful method to select patients with AH in a greatest need of aquatic training.

Evaluation of the Microcirculatory Effects of Venoruton (H.R.) in Patients with Chronic Venous Hypertension by Laser-Doppler Flowmetry, Transcutaneous PO2 and PCO2 Measurements, Leg Volumetry and Ambulatory Venous Pressure Measurements

1989 ◽  
Vol 4 (1) ◽  
pp. 23-29 ◽  
Author(s):  
G. Belcaro ◽  
A. Rulo ◽  
C. Candiani
Keyword(s):  
Placebo Group ◽  
Marked Effect ◽  
Symptomatic Relief ◽  
Venous Pressure ◽  
Skin Irritation ◽  
Active Treatment Group ◽  
Venous Hypertension ◽  
Controlled Study ◽  
Doppler Flowmetry ◽  
Scale Line

The effect of Venoruton on the symptoms and microcirculation was investigated in an open randomised placebo controlled study involving 35 patients with chronic venous hypertension. Treatment was for 6 weeks. There was a significant symptomatic relief (ache, cramps, skin irritation and swelling) according to an analogue scale line score in the active treatment group, but not in the placebo group. The symptomatic relief in this group was associated with a reduction in leg volume ( p < 0.5), resting and standing skin blood flow ( p < 0.05), restoration of the venoarteriolar reflex, a decrease in transcutaneous PO2 ( p < 0.01) an increase in PO2 ( p < 0.05). These parameters did not change in the placebo group. The results of this study demonstrate that Venoruton therapy has a marked effect on the microcirculation and indicate possible mechanisms of the relief of symptoms.

Effect of leg elevation on healing, venous velocity and ambulatory venous pressure in venous ulceration

2005 ◽  
Vol 20 (2) ◽  
pp. 87-94 ◽  
Author(s):  
F P Dix ◽  
B Reilly ◽  
M C David ◽  
D Simon ◽  
E Dowding ◽  
...  
Keyword(s):  
Ulcer Healing ◽  
Femoral Vein ◽  
Venous Pressure ◽  
Current Treatment ◽  
Leg Ulcers ◽  
Venous Flow ◽  
Cross Sectional ◽  
Venous Ulceration ◽  
Postural Changes ◽  
Venous Surgery

Objective: Current treatment of venous leg ulcers (VLU) includes four-layer bandaging, appropriate superficial venous surgery and leg elevation. The aims of this study were to: investigate a device designed to measure leg elevation; assess how long patients elevate; and to assess the effect of elevation on ulcer healing, femoral vein velocity (FVV) and popliteal vein cross-sectional area (PVCSA), and venous pressure. Patients and methods: A datalogger and accelerometer were manufactured to measure leg elevation. The device was validated in eight control subjects; elevation was measured in 24 patients with VLU. Ulcers were traced over six weeks in 29 patients and elevation measured to correlate healing with elevation. Ten patients and 10 controls underwent duplex measurement of FVV and PVCSA to measure flow in relation to posture; nine patients underwent measurement of venous pressure with postural changes. Non-parametric statistical analysis was used. Results: The datalogger accurately recorded all episodes of elevation. Median (range) elevation time was 53 (0–350) mins/24 h; correlation between ulcer healing and elevation was poor at 0.103 ( P=0.616, Spearman); change in posture from sitting to supine produced a significant increase in median (range) FVV from 11 (7–24) to 34 (22–66) in VLU ( P=0.005) and 15 (12–34) to 38 (16–69) in controls ( P=0.005, Wilcoxon). Change in posture from supine to 25 degrees elevation produced no change in FVV in either group ( P=0.173 in VLU, P=0.327 in controls, Wilcoxon). In VLU, sitting PVCSA was 1.07 (0.51–1.45) cm2. Supine position significantly reduced the area to 0.46 (0.27–1.01) cm2 ( P=0.005, Wilcoxon). On elevation to 25°, PVCSA was further reduced to 0.28 (0.07–0.63) cm2 ( P=0.058, Wilcoxon). In controls, sitting PVCSA was 0.79 (0.31–1.56) cm2, supine was reduced to 0.46 (0.27–1.09) cm2 ( P=0.047, Wilcoxon) and on elevation was reduced to 0.23 (0.10–0.44) cm2 ( P=0.005, Wilcoxon). Venous pressure standing was 99 (73–116) mmHg, reduced to 76 (53–113) mmHg on sitting ( P=0.084), and further reduced to 23 (7–36) mmHg supine ( P=0.008, Wilcoxon). Conclusions: Leg elevation in patients with VLU is poor but can be accurately measured. Elevation in the presence of compression may not improve ulcer healing. Postural changes of the leg can produce an increase in deep venous flow and a reduction in venous pressure.

scholarly journals Venous Stasis Leg Ulcers: A Review

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
David Gaus
Keyword(s):  
Venous Return ◽  
Venous Pressure ◽  
Venous Hypertension ◽  
Chronic Venous Disease ◽  
Venous Stasis ◽  
Venous Disease ◽  
Leg Ulcers ◽  
Contributing Factors ◽  
Venous Outflow ◽  
Calf Muscle Pump

Chronic venous stasis ulcers (CVSU) of the lower extremity affect up to 5% of the population over 65 years and 1.5% of the general population. CVSU is caused by chronic venous disease produced by venous hypertension. Venous hypertension results from valvular incompetence within the deep venous system, or by the obstruction of venous outflow. Both of these mechanisms produce poor venous return. Additionally, poor mobility and decreased calf muscle pump function are thought to be contributing factors. Life-long use of compressive therapy is indicated in patients with chronic venous disease in lower extremities. It reduces ambulatory venous pressure. These include bandaging systems, garments (stockings), or devices.

Abnormal venous function in patients with homozygous sickle cell (SS) disease and chronic leg ulcers

2000 ◽  
Vol 98 (6) ◽  
pp. 667-672 ◽  
Author(s):  
Junette S. MOHAN ◽  
Jacqueline E. VIGILANCE ◽  
Janice M. MARSHALL ◽  
Ian R. HAMBLETON ◽  
Harvey L. REID ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Venous Pressure ◽  
Venous Blood ◽  
Venous Occlusion ◽  
Leg Ulcers ◽  
Venous Capacitance ◽  
Doppler Flowmetry ◽  
Venous Valves ◽  
Venous Ulcers ◽  
Venous Function

Chronic leg ulceration is a major cause of morbidity in homozygous sickle cell (SS) disease in Jamaica. These ulcers have features in common with venous ulcers in patients with a normal haemoglobin genotype (AA). Thus we sought to determine whether there is abnormal venous function in the legs of patients with SS disease who have ulcers. Experiments were performed on 15 SS patients with ulcers, and on 15 SS patients and 15 AA subjects with no history of leg ulcers. Changes in venous blood volume of the bottom one-third of the leg induced by venous occlusion and release were studied by air plethysmography, providing indices of segmental venous capacitance (SVC), maximal venous outflow (MVO) and venous emptying time (VET). The changes in volume (ambulatory volume change; AVC) induced by a period of leg exercise were also measured at the ankle (AVCa) and calf (AVCc); venous refilling times at these sites (RTa and RTc respectively) were also measured. Finally, cutaneous red blood cell flux recovery time (FRT) after ankle exercise was assessed by laser Doppler flowmetry. Measurements were also made of haematological variables. SVC, MVO and VET did not differ between the groups, indicating no deep venous obstruction in the SS patients with ulcers. AVCc, AVCa and RTc did not differ among the three subject groups. However, compared with AA subjects, SS patients with ulcers had reduced RTa and FRT. Moreover, RTa and FRT were further shortened in SS patients with ulcers relative to SS patients without ulcers. Since the levels of anaemia were similar in SS patients with and without ulcers, these differences cannot be attributed to differences in arterial flow secondary to anaemia. These results suggest abnormal venous function in SS patients with ulcers, relative to both AA subjects and SS patients without ulcers. We propose that there is incompetence of venous valves draining the ankle region of SS patients with ulcers: the consequent raised venous pressure contributes to the slow healing and, possibly, to the onset of leg ulceration in SS disease.

Treatment of venous leg ulcers with sulodexide

Phlebologie ◽  
2003 ◽  
Vol 32 (05) ◽  
pp. 115-120 ◽  
Author(s):  
A. Franek ◽  
H. Koziolek ◽  
M. Kucharzewski
Keyword(s):  
Pharmacological Treatment ◽  
Healing Process ◽  
Leg Ulcers ◽  
Venous Ulceration ◽  
Venous Leg Ulcers ◽  
Group I ◽  
Group Ii

SummaryAim: The study of the influence of sulodexide in the treatment of venous leg ulcers. Patients and method: 44 patients with chronic venous ulceration were randomly divided into two groups. Group I: 21 patients (ulceration area: 12.7-18.9 cm2), Group II: 23 patients (ulceration size: 12.1-20.3 cm2). Both groups were treated by using Unna’s boot. This dressing was changed every seven days until the ulcer had healed. Additionally, the patients in group II received the systemic pharmacological treatment with sulodexide. Results: After 7 weeks of treatment ulcers of seven patients (35%) from group I had healed, and 3 weeks later the ulceration of two more patients had healed completely. After further 7 weeks the ulcers of 12 patients had healed completely. Whereas in group II after 7 weeks of treatment ulceration of 16 (70%, p <0.05) patient had healed completely and after further 3 weeks the ulcers of the remaining 7 patients had healed, too. Conclusion: The use of sulodexide in patients with chronic venous leg ulcers accelerates the healing process.

Therapeutic use of lowmolecular weight heparin for capillaritis alba

Phlebologie ◽  
2008 ◽  
Vol 37 (05) ◽  
pp. 259-265 ◽  
Author(s):  
H. Kutzner ◽  
G. Hesse
Keyword(s):  
Case Studies ◽  
Randomized Study ◽  
Compression Therapy ◽  
Venous Hypertension ◽  
Therapeutic Use ◽  
Prospective Randomized Study ◽  
Anti Inflammatory ◽  
Positive Effect ◽  
Inflammatory Effect

SummaryThe reason of the so called ulcerated capillaritis alba or idiopathic atrophie blanche is vasculopathy caused by severe venous hypertension. Thrombosed and rarificated vessels worsen the oxygenation, increase permanent inflammation and impede the necessary compression therapy. The anti-inflammatory effects of heparin alleviate pain and being independent from the antithrombotic ones it needs much lower doses for treatment. This anti-inflammatory effect is now becoming more important in clinical phlebology. Case studies of more than 50 patients and one prospective randomized study of 87 patients clearly demonstrate the ameliorated healing of ulcerated atrophie blanche. In our office we could document this positive effect with 22 patients. We present the pathophysiology of low molecular heparins for ulcerated capillaritis alba and our own experiences with it.

Tissue Plasminogen Activator Release in Chronic Venous Hypertension due to Heart Failure

1992 ◽  
Vol 68 (03) ◽  
pp. 321-324 ◽  
Author(s):  
Irena Keber ◽  
Dušan Keber ◽  
Mojca Stegnar ◽  
Nina Vene
Keyword(s):  
Heart Failure ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Fibrinolytic Activity ◽  
Venous Pressure ◽  
Venous Hypertension ◽  
Plasminogen Activator Inhibitor 1 ◽  
Control Subjects ◽  
Tissue Plasminogen ◽  
Pai 1

SummaryIn order to study the effects of chronic venous hypertension due to heart failure on blood fibrinolytic activity, tissue plasminogen activator (t-PA) antigen, plasminogen activator inhibitor 1 (PAI-1) antigen, t-PA activity and PAI activity were measured before and after venous occlusion of the arm for 20 min in 15 patients with right-sided heart failure, 15 patients with left-sided heart failure, and 30 control healthy subjects. Central venous pressure, measured by observing the jugular veins, was above 15 cm of the blood column in all patients with right-sided heart failure, and normal (below 8 cm) in all patients with left-sided heart failure and control subjects. There was no difference in the basal concentrations of t-PA (11.0, 10.2 and 10.8 ng/ml; all values medians) and PAI-1 antigens and their activities between right and left-sided heart failure and the control subjects. After the occlusion, t-PA antigen increased significantly less in right-sided heart failure (28.6 ng/ml) than in left-sided heart failure and the control subjects (54.5 and 45.9 ng/ml, respectively). It was concluded that the poor increase in fibrinolytic activity that had already been reported in patients with heart failure, was due to low t-PA release during occlusion and not to a high basal PAI level. It was limited to the patients with right-sided heart failure and was probably the consequence of chronic systemic venous hypertension.

ANALISIS EFEKTIVITAS PROGRAM USAHA AGRIBISNIS PERDESAAN (PUAP) SERTA DAMPAKNYA TERHADAP TINGKAT PENDAPATAN PETANI (STUDI KASUS PADA GABUNGAN KELOMPOK TANI TELUK JAYA)

2014 ◽  
Vol 5 (2) ◽  
Author(s):  
Yudi Triyanto
Keyword(s):  
Poverty Alleviation ◽  
F Test ◽  
Income Levels ◽  
Before And After ◽  
Program Funding ◽  
Independent Variable ◽  
Farmer Income ◽  
Positive Effect ◽  
Group Association

Study the effectivity analysis of Program Usaha Agribisnis Perdesaan (PUAP) and its impact on farmer income levels (case study of the Teluk Jaya Farmers Group Association) aims to 1. knowing how large the effectivity of PUAP funds is for income levels in poverty alleviation in Teluk Desa Sentosa Panai Hulu Subdistrict, 2. to analyze and determine the level of income of Gapoktan Teluk Jaya Farming Business in Teluk Sentosa, Panai Hulu Subdistrict before and after receiving PUAP assistance. The results showed that the effectivity of PUAP program funding is very effective and good, it can be seen from the results of the F test of 12.406 with a significant level of 0.000 while the F value of the table is 2.051. When compared to the value of F test (12.406) > Ftable (2.051) at α 5%, it was concluded that simultaneously the effectivity variable and the PUAP program had a positive effect. The increase in income of the Teluk Jaya Farmers Group in Teluk Sentosa after receiving PUAP funds can be known from the t table for the effectivity variable of 2.663 and the PUAP program for 1.270 with a significant value for each independent variable (2.051); (0.073). Whereas for the t table value in the distribution statistics t table with the level of test α = 5% and df1 = 27 of 2,051. Based on the criteria that if the value is t count> t table); namely (2.663> 2,051) (1,270> 2,051) so that it can be concluded that the effectivity variable partially has a positive and significant effect on the income level.Keywords : effectivity variable,  income level, PUAP program

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