The Relationship between Ultrasonic Ambulatory Venous Pressure and Residual Volume Fraction in Primary Venous Insufficiency

1999 ◽  
Vol 14 (4) ◽  
pp. 146-150
Author(s):  
P. Zamboni ◽  
D. Quaglio ◽  
C. Cisno ◽  
F. Marchetti ◽  
L. Cisno ◽  
...  

Objective: To study the relationship between two non-invasive methods for determining ambulatory venous pressure (AVP) in primary chronic venous insufficiency of the lower limbs. Design: Comparison between ultrasonic AVP (US-AVP) and residual volume fraction (RVF) determined by means of air plethysmography (APG). Setting: Department of Surgery and Vascular Laboratory, University of Ferrara, Italy. Patients: Twenty-one subjects affected by primary chronic venous insufficiency (CVI). Main outcome measure: A comparison of the AVP values extrapolated from the change in ultrasonic diameter of the saphenous vein after exercise and from RVF values. Ultrasonographic extrapolation was also made by the means of the software Venometer and compared with manual assessment. Results: Linear regression analysis demonstrated that US-AVP values were significantly correlated with RVF values ( r = 0.86 and p<0.0001). Assessment by Venometer as compared with manual calculation showed a high degree of correlation ( r = 0.98), p<0.0001). Conclusions: The two methods for non-invasive assessment of AVP appear to be closely and significantly correlated. The Venometer allows reliable and rapid extrapolation of AVP values.

1999 ◽  
Vol 14 (4) ◽  
pp. 146-150
Author(s):  
P. Zamboni ◽  
D. Quaglio ◽  
C. Cisno ◽  
F. Marchetti ◽  
L. Cisno ◽  
...  

Author(s):  
A. B. Sannikov ◽  
V. M. Emelyanenko ◽  
I. V. Drozdova

Plethysmography as a method for studying peripheral circulatory system was first proposed by wletney in 1953. In Russia, the first most significant research studies on the feasibility of plethysmography in studying peripheral blood flow and circulatory physiology taken together were conducted at the St. Petersburg Pavlov Institute of Physiology in 1961. From this time onwards, the possibilities of plethysmography as a non-invasive objective method for the diagnosis of hemodynamic disorders, particularly in arterial pathology, were studied intensively. These parameters were not determined for the venous blood flow, but in 1980s the authors were able to establish plethysmographic criteria not only for various forms of venous pathology, but also for degrees of chronic venous insufficiency using a device significantly improved by V.N. Pavlov and V.E. Maslov.The purpose of this publication is to analyze the literature data on the use of aerial plethysmography and photoplethysmography in the study of hemodynamic disorders in patients with chronic diseases of the veins of the lower extremities. At present, in order to assess the venous blood flow in condition of air plethysmography, indicators of functional venous volume (VV), maximum venous outflow (MVO), venous filling index (VFI), evacuation volume (EV) and residual volume (RV), as well as an integral indicator – residual volume fraction (RVF) are determined in the world. A venous reflux test (VRT) is performed as part of photoplethysmography. The data published today show the high statistical reliability of the comparative analysis and the great scientific significance of the research. According to many foreign authors the use of plethysmographic methods of diagnosis allow to assess violations of venous blood flow in patients with chronic venous diseases of various clinical classes according to CEAP more precisely and to give a global assessment of disorders of the venous outflow from thrombotic occlusion of segmental to hypervolemia in patients with varicose veins in different forms of manifestations of chronic venous insufficiency. The analysis of the literature data allows to make a conclusion about the prospects of further research using these non-invasive methods of evaluation of venous blood flow in the lower extremities.


1996 ◽  
Vol 91 (4) ◽  
pp. 483-488 ◽  
Author(s):  
M. C. H. Janssen ◽  
J. A. H. R. Claassen ◽  
W. N. J. C. Van Asten ◽  
H. Wollersheim ◽  
M. J. M. De Rooij ◽  
...  

1. A new non-invasive test was developed to assess calf muscle pump function: the supine venous pump function test. The technique uses strain-gauge plethysmography and is performed in the supine position. The method is superior to other non-invasive methods because basically the most essential haemodynamic parameter, venous pressure decrease, is used by properly converting venous volume measurements into venous pressure. The validity of this test was established by comparison with invasive venous pressure measurements and by determining the reproducibility. Additionally, normal values were determined. 2. In 28 extremities the supine venous pump function test was performed simultaneously with invasive venous pressure measurements. The reproducibility of the test was assessed in 10 randomly chosen volunteers. In 34 volunteers normal values were obtained and 26 patients with clinical venous insufficiency were examined. 3. Comparison of the two methods revealed a correlation coefficient of r = 0.98 (P < 0.001). A mean difference of 3.9%pf between both methods was found with limits of agreement of − 6.3%pf to 14.1%pf. The coefficient of repeatability was 13%pf and the coefficient of variation was 9%. The normal range was found to be >60%pf. The mean pump function in the patient group was 45%pf. 4. The limits of agreement are small enough to be confident that the supine venous pump function test can be used instead of invasive venous pressure measurements to assess calf muscle pump function in clinical practice. The reproducibility of the test is good.


Author(s):  
Deepak Sharma ◽  
Sachin Lamba ◽  
Aakash Pandita ◽  
Sweta Shastri

Klippel–Trénaunay syndrome (KTS or KT) is an infrequently seen dermatological syndrome, which is often viewed as a triad of vascular malformation (capillary malformations or port-wine brands), venous varicosity, and soft tissue and/or bony hypertrophy. We report a case of a 12-year-old male who presented to us with the symptoms of varicose plaques over both lower limbs and was diagnosed as a case of KTS. Management is normally conservative and includes stockings for compression of the branches to reduce edema because of chronic venous insufficiency; modern devices that cause on and off pneumatic compression; and rarely, surgical correction of varicose veins with lifelong follow-up. The orthopedic abnormalities are treated with epiphysiodesis in order to prevent (stop) overgrowing of limb and correction of bone deformity.


2015 ◽  
Vol 4 (1) ◽  
Author(s):  
Leonardo Corcos ◽  
Daniele Pontello ◽  
Tommaso Spina

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.


Angiology ◽  
2005 ◽  
Vol 56 (6_suppl) ◽  
pp. S21-S24 ◽  
Author(s):  
John J. Bergan

Chronic venous insufficiency is linked to venous hypertension and forces of shear stress on the endothelium. Venous hypertension depends upon two forces: the weight of a column of blood from the right atrium transmitted through the valveless vena cava and iliac veins to the femoral vein, and pressure generated by contracting skeletal muscles of the leg transmitted through failed perforating veins. When valve failure occurs in superficial axial veins and perforating veins, the venous pressure in the veins and venules of the skin and subcutaneous tissue is raised. The skin changes in chronic venous insufficiency are directly related to the severity of the venous hypertension. Also, pathologic changes in the valves are linked to venous hypertension and leukocyte infiltration and activation. It is hypothesized that acute venous pressure elevations cause a shift in the venous hemodynamics with changes in wall shear stress. This initiates the inflammatory cascade. Daflon 500 mg ameliorates the effects of chronic inflammation. In randomized trials, 60 days of therapy with Daflon at a dosage of 500 mg 2 tablets daily was effective, in addition to elastic compression, in accelerating venous ulcer healing. Because venous insufficiency is linked to venous hypertension and an inflammatory reaction, it appears that Daflon 500 mg 2 tablets daily shows a great potential for accomplishing blockade of the inflammatory cascade.


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