Do Compression Stockings Potentiate the Fibrinolytic Capacity of the Lower Limbs?

1989 ◽  
Vol 4 (3) ◽  
pp. 161-166 ◽  
Author(s):  
D.C. Berridge ◽  
J.C. Westby ◽  
G.S. Makin ◽  
B.R. Hopkinson
Keyword(s):  
Hydrostatic Pressure ◽  
Lower Limb ◽  
Fibrinolytic Activity ◽  
Varicose Veins ◽  
Bed Rest ◽  
Lower Limbs ◽  
Clot Lysis ◽  
Compression Stockings ◽  
Occlusion Time ◽  
The Right

Patients with varicose veins and liposclerosis have been shown to have impaired fibrinolytic activity1. Furthermore, fibrinolytic activity is much reduced in the lower than in the upper limbs, probably due to the difference in hydrostatic pressure. After 2–10 days bed rest a significant increase in potential is observed2. Compression support stockings can exert 30–40 mmHg of pressure which is 50% of the normal hydrostatic pressure. Therefore does the long term use of such stockings cause a significant increase in fibrinolytic potential? Seventeen patients (10 male, 7 female; mean age 52.8 +/— 9.8 yrs) with features of liposclerosis were studied. Pre- and post-euglobulin clot lysis times (ELT) were measured in the right arm and both legs using a 10 min occlusion time. The patients contralateral leg served as the control. Sigvaris stockings were made for each patient to wear on the designated leg only. Measurements were repeated after 1 and 3 months of use with the stocking in situ and after 30 min bed rest. Patients were instructed to wear the stockings at all times during the day. There were no significant differences in the pre-occlusion values between the arm or the lower limb groups throughout the study. Lower limb post occlusion ELT values were significantly higher in both the affected limb ( p < 0.002) and the patients control limb ( p < 0.002), than in the arm. This relationship was constant throughout the study period. No significant potentiation was seen after either 1 or 3 months of use. There were no new areas of ulceration throughout the study period. Thus any clinical benefit arising from the use of compression stockings is not from potentiation of local fibrinolysis.

scholarly journals An oral combined contraceptive user with elevated D-dimer post COVID-19: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nada A. Alyousefi
Keyword(s):  
Emergency Room ◽  
Lower Limb ◽  
Varicose Veins ◽  
Hormonal Contraception ◽  
Oral Contraception ◽  
Contraceptive User ◽  
Lower Limb Pain ◽  
The Right ◽  
D Dimer ◽  
Ethinyl Oestradiol

Abstract Background This case discusses the challenges created by COVID-19 (coronavirus disease 2019) in the area of hormonal contraception, highlighting the contraception knowledge gap for women in their post COVID-19 period, especially if they had high D-dimer levels. Case presentation This case involves a thirty-eight-year-old woman taking combined oral contraception (desogestrel/ethinyl oestradiol tablets) with a history of varicose veins. She recovered from a COVID-19 infection in November 2020. She presented to the emergency room with right lower-limb pain below the knee and progressive swelling for five days in February 2021. Physical examination of the lower limb showed mild swelling and tenderness of the right leg compared to the left leg. D-Dimer was elevated (1.06 mcg/mL FEU). COVID-19 screening was negative. A Doppler scan to exclude DVT was performed considering the clinical picture and high D-dimer level. There was no evidence of DVT in the right limb. She was reassured and discharged with instructions on when to visit the emergency room. The D-dimer had decreased to 0.53 mcg/mL FEU in March 2021. She booked an appointment with family medicine clinics because she was concerned about the continuation of combined oral contraception (desogestrel/ethinyl oestradiol tablets) with high D-dimer and risk of thrombosis. The follow-up D-dimer level in May 2021 was normal (0.4 mcg/mL FEU). The patient preferred to continue taking oral contraception. Conclusion An evidence-based consensus is needed to guide clinicians in providing contraception counselling for such patients.

scholarly journals Elastic compression treatment of chronic superficial venous insufficiency of the lower limbs based on Doppler venous pressure index measurements

2015 ◽  
Vol 4 (1) ◽  
Author(s):  
Leonardo Corcos ◽  
Daniele Pontello ◽  
Tommaso Spina
Keyword(s):  
Venous Insufficiency ◽  
Varicose Veins ◽  
Venous Pressure ◽  
Lower Limbs ◽  
Compression Stockings ◽  
Elastic Compression ◽  
Pressure Index ◽  
Counter Pressure ◽  
The Difference ◽  
Compression Treatment

Ineffectiveness or discomfort from graduated elastic compression stockings (GES) in patients with chronic venous insufficiency (CVI) and/or varicose veins of the lower limbs (VVLL) can depend of inappropriate counter pressure applied. Counter pressure was calculated by Doppler venous pressure index (VPI). The aim of this study was to verify the value VPI in the choice of GES. A total of 1212 LL of 606 patients subjected to VPI measurements VPI correlated with the various sites of reflux (R) and C of Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification. The difference between standing VPI the and normal values=counter pressure to be applied by GES. Questionnaire to 96 patients with CVI/VVLL wearing GES. Mean VPI values: greater saphenous (GSV)&gt;smaller saphenous; GSV with isolated venous reflux (R) at the leg&gt;GSV at the thigh; additional R in perforators increases VPI in all the districts; superficial R increases VPI in PT. Relation between VPI/C of CEAP: P&lt;0.05-0.0001; 81/83/96 (97.5%) patients improved; 0 complained. R in GSV at the leg and in perforators increases VPI in deep veins. Few discrepancies VPI/CEAP can be expected. Standing VPI is highly predictive. The best choice of GES can be based on the VPI measurement.

scholarly journals Reasons for patient non-compliance with compression stockings as a treatment for varicose veins in the lower limbs: A qualitative study

PLoS ONE ◽  
2020 ◽  
Vol 15 (4) ◽  
pp. e0231218
Author(s):  
Jian-Mei Gong ◽  
Jian-Shi Du ◽  
Dong-Mei Han ◽  
Xin-Yu Wang ◽  
Shao-Long Qi
Keyword(s):  
Qualitative Study ◽  
Varicose Veins ◽  
Lower Limbs ◽  
Compression Stockings

Arteries masquerading as varicose veins: A trap for phlebologists

2014 ◽  
Vol 30 (10) ◽  
pp. 729-735 ◽  
Author(s):  
L Jones ◽  
K Parsi
Keyword(s):  
Saphenous Vein ◽  
Lower Limb ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Tissue Loss ◽  
Injection Sclerotherapy ◽  
Ultrasound Guided ◽  
History Of ◽  
The Right

Ultrasound guided sclerotherapy may be complicated by intra-arterial injections resulting in significant tissue necrosis. Here, we present a 69-year-old man with a history of right small saphenous vein “stripping”, presenting for the treatment of symptomatic lower limb varicose veins. Duplex ultrasound of the right lower limb outlined the pathway of venous incompetence. Despite the history of “stripping”, the small saphenous vein was present but the sapheno-popliteal junction was ligated at the level of the knee crease. No other unusual findings were reported at the time. During ultrasound guided sclerotherapy, subcutaneous vessels of the right posterior calf were noted to be pulsatile on B-mode ultrasound. Treatment was interrupted. Subsequent angiography and sonography showed absence of the right distal popliteal artery. A cluster of subcutaneous vessels of the right medial and posterior calf were found to be arterial collaterals masquerading as varicose veins. Injection sclerotherapy of these vessels would have resulted in significant tissue loss. This case highlights the importance of vigilance at the time of treatment and the invaluable role of ultrasound in guiding endovenous interventions.

scholarly journals An Evaluation of Symmetry in the Lower Limb Joints During the Able-Bodied Gait of Women and Men

2012 ◽  
Vol 35 (1) ◽  
pp. 47-57 ◽  
Author(s):  
Wanda Forczek ◽  
Robert Staszkiewicz
Keyword(s):  
Lower Limb ◽  
Sagittal Plane ◽  
Temporal Structure ◽  
Asymmetry Index ◽  
Lower Limbs ◽  
Inclusion Criteria ◽  
3D Motion Analysis ◽  
Spatio Temporal ◽  
Analysis System ◽  
The Right

For many years, mainly to simplify data analysis, scientists assumed that during a gait, the lower limbs moved symmetrically. However, even a cursory survey of the more recent literature reveals that the human walk is symmetrical only in some aspects. That is why the presence of asymmetry should be considered in all studies of locomotion. The gait data were collected using the 3D motion analysis system Vicon. The inclusion criteria allowed the researchers to analyze a very homogenous group, which consisted of 54 subjects (27 women and 27 men). Every selected participant moved at a similar velocity: approximately 1,55 m/s. The analysis included kinematic parameters defining spatio-temporal structure of locomotion, as well as angular changes of the main joints of the lower extremities (ankle, knee and hip) in the sagittal plane. The values of those variables were calculated separately for the left and for the right leg in women and men. This approach allowed us to determine the size of the differences, and was the basis for assessing gait asymmetry using a relative asymmetry index, which was constructed by the authors. Analysis of the results demonstrates no differences in the temporal and phasic variables of movements of the right and left lower limb. However, different profiles of angular changes in the sagittal plane were observed, measured bilaterally for the ankle joint.

Causes of recurrent lower limb varicose veins after surgical interventions in 141 limbs – Five-year retrospective analysis of two centers

Vascular ◽  
2013 ◽  
Vol 22 (4) ◽  
pp. 267-273 ◽  
Author(s):  
Wang Rui Hua ◽  
Meng Qing Yi ◽  
Wu Xue Jun ◽  
Jin Xing ◽  
Liu Zhao Xuan ◽  
...  
Keyword(s):  
Lower Limb ◽  
Varicose Veins ◽  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Lower Limbs ◽  
Venous Reflux ◽  
Surgical Interventions ◽  
Venous Valves ◽  
Second Surgery ◽  
Clinical Changes

Aim The purpose of this study was to explore the causes of recurrent lower limb varicose veins after surgical interventions. Methods A retrospective five-year survey was conducted on patients who underwent second surgery due to recurrent lower limb varicose veins after surgical interventions. A total of 141 limbs (112 cases), including 72 cases of left lower limbs, 47 of right lower limbs and 22 of both limbs, were involved in the study. All patients underwent lower limb venography (141 limbs were anterograde and 28 cases were retrograde), and then examined with color-Doppler ultrasound. Results The major causes that urged patients to undergo second surgery are clinical changes graded above CEAP IV (93.6%), limb edema without changes on skin (5%), and single varicosity (1.4%). Up to 127 (83%) limbs exhibited perforating venous reflux, 67 (47.5%) limbs had varied degrees of deep venous insufficiency and 68 (48.2%) limbs had through or above-the-knee great saphenous vein trunk residual. Conclusions Preoperative venography before operation is indispensible in confirming the diagnosis and operation strategies. Patients with severe primary deep venous reflux and symptoms up to C3 may need simultaneous repair of the deep venous valves.

scholarly journals Pre- and Postoperative Evaluation by Photoplethysmography in Patients Receiving Surgery for Lower-Limb Varicose Veins

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Orlando Adas Saliba Júnior ◽  
Mariangela Giannini ◽  
Ana Paula Mórbio ◽  
Orlando Saliba ◽  
Hamilton Almeida Rollo
Keyword(s):  
Lower Limb ◽  
Varicose Veins ◽  
Lower Limbs ◽  
Varicose Vein Surgery ◽  
Postoperative Evaluation ◽  
Perforating Veins ◽  
Primary Varicose Veins ◽  
Ceap Classification ◽  
The Mean ◽  
Deep Vein

Objective. To evaluate the effectiveness of surgery in treating primary varicose veins in the lower limbs by photoplethysmography (PPG) and duplex mapping (DM).Method. Forty-eight lower limbs were clinically evaluated according to the CEAP classification system and subjected to PPG and DM exams. Each limb had a venous refill time (VRT) of <20 seconds and a normal deep vein system (DVS) by DM.Results. The mean pre- and postoperative VRTs were 13.79 and 26.43 seconds, respectively (P<0.0001). After surgery, 42 limbs (87.50%) had normal results by PPG (VRT > 20 seconds). Four limbs (8.33%) showed improved VRTs, but the VRTs did not reach 20 seconds. In the 2 limbs (4.17%) that maintained their original VRTs, the DM exams showed the presence of insufficient perforating veins.Conclusion. In most cases, PPG allows for a satisfactory evaluation of the outcome of varicose vein surgery.

scholarly journals Diagnosis of stenosis within the popliteal–femoral venous segment upon clinical presentation with a venous ulcer and subsequent successful treatment with venoplasty

2017 ◽  
Vol 5 ◽  
pp. 2050313X1774051
Author(s):  
Emma Dabbs ◽  
Alina Sheikh ◽  
David Beckett ◽  
Mark S Whiteley
Keyword(s):  
Saphenous Vein ◽  
Lower Limb ◽  
Varicose Veins ◽  
Venous Ulcer ◽  
Distal Region ◽  
Duplex Ultrasonography ◽  
Venous Ulceration ◽  
Venous Collaterals ◽  
The Right ◽  
Venous Segment

This case study reports the diagnosis and treatment of a lower limb venous ulcer with abnormal underlying venous pathology. One male patient presented with bilateral varicose veins and a right lower limb ulcer. Upon investigation, full-leg duplex ultrasonography revealed total incompetence of the great saphenous vein in the left leg. In the right leg, duplex ultrasonography showed proximal incompetence of the small saphenous vein, and dilation of the anterior accessory saphenous vein, which remained competent. Incidentally, two venous collaterals connected onto the distal region of both these segments, emerging from a scarred, atrophic popliteal–femoral segment. An interventional radiologist performed venoplasty to this popliteal–femoral venous segment. Intervention was successful and 10 weeks post procedure ulceration healed. Popliteal–femoral venous stenosis may be associated with venous ulceration in some cases and may be successfully treated with balloon venoplasty intervention.

scholarly journals Temporal and spatial asymmetries during stationary cycling cause different feedforward and feedback modifications in the muscular control of the lower limbs

2018 ◽  
Author(s):  
Magdalena Zych ◽  
Ian Rankin ◽  
Donal Holland ◽  
Giacomo Severini
Keyword(s):  
Lower Limb ◽  
Motor Adaptation ◽  
Neuromuscular Control ◽  
Task Demands ◽  
Lower Limbs ◽  
Muscle Synergy ◽  
Accelerometer Data ◽  
Temporal Asymmetry ◽  
Spatial Asymmetries ◽  
The Right

AbstractMotor adaptations are useful for studying the way in which the lower limbs are controlled by the brain. However, motor adaptation paradigms for the lower limbs are typically based on locomotion tasks, where the necessity of maintaining postural stability is the main driver of adaptation and could possibly mask other underlying processes. In this study we investigated whether small temporal or spatial asymmetries can trigger motor adaptations during stationary cycling, where stability is not directly compromised. Fourteen healthy individuals participated in two experiments: in one of the experiments the angle between the crank arms of the pedals was altered by 10° to induce a temporal asymmetry; in the other the length of the right pedal was shortened by 2.4 cm to induce a spatial asymmetry. We recorded the acceleration of the crank arms and the EMG signals of 16 muscles (8 per leg). The analysis of the accelerometer data was used to investigate the presence of motor adaptations. Muscle synergy analysis was performed on each side to quantify changes in neuromuscular control. We found that feedforward motor adaptations are present in response to temporal asymmetries and are obtained by progressively shifting the activation patterns of two synergies on the right leg. Spatial asymmetries appear to trigger a feedback-driven response that does not present an aftereffect and is not consistent with a motor adaptation. This response is characterized by a step-like decrease in activity in the right gastrocnemius when the asymmetry is present and likely reflects the altered task demands.New and NoteworthyThe processes driving lower limb motor adaptations are not fully clear, and previous research appears to indicate that adaptations are mainly driven by stability. Here we show that lower limb adaptations can be obtained also in the absence of an explicit balance threat. We also show that adaptations are present also when kinematic error cannot be compensated for, suggesting the presence of intrinsic error measures regulating the timing of activation of the two legs.

scholarly journals Asymmetry and changes in the neuromuscular profile of short-track athletes as a result of strength training

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261265
Author(s):  
Paweł Pakosz ◽  
Anna Lukanova-Jakubowska ◽  
Edyta Łuszczki ◽  
Mariusz Gnoiński ◽  
Oscar García-García
Keyword(s):  
Strength Training ◽  
Lower Limb ◽  
Female Athletes ◽  
Lower Limbs ◽  
Lower Limb Muscles ◽  
Limb Muscles ◽  
Before And After ◽  
Monthly Period ◽  
Track Athletes ◽  
The Right

Background The purpose of this study was to identify the biomedical signals of short-track athletes by evaluating the effects of monthly strength training on changes in their neuromuscular profile, strength, and power parameters of the lower limb muscles. Muscle asymmetry, which can cause a risk of injury, was also evaluated. Methods and results This study involved female athletes, age 18.8 ± 2.7 years, with a height of 162 ± 2.4 cm, and weight of 55.9 ± 3.9 kg. Before and after the monthly preparatory period prior to the season, strength measurements were assessed through the Swift SpeedMat platform, and reactivity of the lower limb muscles was assessed with tensiomyography (TMG). The athletes were also tested before and after the recovery training period. In the test after strength training, all average countermovement jump (CMJ) results improved. Flight time showed an increase with a moderate to large effect, using both legs (5.21%). Among the TMG parameters, time contraction (Tc) changed globally with a decrease (-5.20%). Changes in the results of the test after recovery training were most often not significant. Conclusion A monthly period of strength training changes the neuromuscular profile of short-track female athletes, with no significant differences between the right and left lower limbs.

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