Microangiopathy in Chronic Venous Insufficiency before and after Sclerotherapy and Compression Treatment: Results of a One-Year Follow-up Study

1993 ◽  
Vol 8 (3) ◽  
pp. 99-106 ◽  
Author(s):  
A. J. Leu ◽  
A. Yanar ◽  
M. Geiger ◽  
U. K. Franzeck ◽  
A. Bollinger
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Compression Therapy ◽  
Laser Doppler ◽  
University Hospital ◽  
Functional Changes ◽  
Severe Stage ◽  
Before And After ◽  
One Year ◽  
Doppler Flux

Objective: To characterize microangiopathy in patients with chronic venous insufficiency (CVI) of a moderate to severe stage and to evaluate improvement of the microcirculatory parameters after sclerotherapy of incompetent perforators and compression therapy. Design: Fluorescence videomicroscopy (Na-fluore-scein), laser Doppler fluxmetry and tc Po2 measurements (43°C) at the medial ankle in healthy controls and patients. Laser Doppler flux and tc Po2 were recorded in supine and sitting position in order to evaluate postural vasoconstriction. The measurements were repeated 6 and 12 months after sclerotherapy of incompetent perforators (Polidocanol 40 mg/ml) and compression therapy by below-knee class II or III stockings (Sigvaris®). Setting: Department of Internal Medicine, Angiology Division, University Hospital, Zurich, Switzerland. Patients, participants: 15 healthy subjects (15 legs, mean age 53.3 years) and 15 patients with CVI of a moderate to severe stage (17 legs, mean age 56.8 years). Results: Microangiopathy in CVI is characterized by significantly enlarged, elongated and dilated capillaries with increased diameters of the pericapillary spaces (‘halos’). Single capillaries may be thrombosed. Laser Doppler flux is increased and tc Po2 is decreased. After therapy, there was a trend to decreased laser Doppler flux and an increase in tc Po2, but the differences were not statistically significant. Capillary thromboses were no longer detected. Mean halo diameters tended to decrease, but this difference was not statistically significant. Conclusions: Microangiopathy in CVI is characterized by morphological and functional changes. Beneficial changes induced by therapy develop slowly and emphasize the importance of long-lasting treatment.

Cutaneous Blood Flow in Legs with Severe Chronic Venous Insufficiency Recorded before and after a Single Treatment Using Intermittent Pneumatic Compression

1996 ◽  
Vol 11 (1) ◽  
pp. 30-33 ◽  
Author(s):  
K. Malanin ◽  
P. J. Kolari ◽  
A. Haapanen ◽  
I. Helander ◽  
V. K. Havu
Keyword(s):  
Chronic Venous Insufficiency ◽  
Healthy Subjects ◽  
Venous Insufficiency ◽  
Intermittent Pneumatic Compression ◽  
Laser Doppler ◽  
Sitting Position ◽  
Single Treatment ◽  
Recumbent Position ◽  
Doppler Flowmetry ◽  
Before And After

Objective: To investigate the skin laser Doppler flux (LDF) in legs with severe chronic venous insufficiency (CVI). Design: Comparison of the legs with severe CVI with the healthy legs and with the patients' contralateral legs. Setting: Department of Dermatology, University of Turku, Turku, Finland. Patients and control subjects: Ten patients and eight age-matched subjects with healthy legs. Interventions: A single treatment using intermittent pneumatic compression (IPC) of 45 min duration. Main outcome measures: Laser Doppler flowmetry with the subjects in a recumbent and a sitting position. Results: The LDF values were higher for the legs with severe CVI than for the legs of healthy subjects ( p<0.001 in a recumbent and p<0.01 in a sitting position). A single IPC increased the LDF in a recumbent position in the patients' legs with severe CVI ( p=0.019) but had no significant effect on the LDF value in the sitting position. The venoarteriolar response was significantly better in the legs with severe CVI than in the legs of healthy subjects ( p<0.05). Conclusions: The LDF is increased in legs with severe CVI and a single IPC further increases it in a recumbent position. The venoarteriolar response is not impaired in legs with severe CVI.

Microcirculation disturbances in different stages of chronic venous insufficiency

Phlebologie ◽  
2001 ◽  
Vol 30 (01) ◽  
pp. 11-15 ◽  
Author(s):  
Pavel Poredoš ◽  
Igor Švab ◽  
Josip Car ◽  
Blaž Mlačak
Keyword(s):  
Chronic Venous Insufficiency ◽  
Healthy Subjects ◽  
Venous Insufficiency ◽  
Cuff Pressure ◽  
Arterial Occlusion ◽  
Flow Regulation ◽  
Venous Hypertension ◽  
Laser Doppler ◽  
Specific Flow ◽  
Doppler Flux

Summary Objectives: The aim of this study was to investigate patients with different clinical stages of chronic venous insufficiency (CVI) by laser Doppler fluxmetry (LDF) in order to asses whether these clinical entities correspond to specific flow regulation. Methods: 3 groups of subjects were incorporated in the study. Microcirculation investigations were carried out at rest and after hemodynamics tests. Changes in the laser Doppler flux minus the biological zero value were measured after 3 minutes of arterial occlusion and by experimental venous hypertension (40 and 70 mmHg) and expressed relatively to the pretest resting value. Results: Resting LDF was significantly higher in patients with CVI II and CVI III stage as compared to the both groups with healthy subjects and the group with CVI I stage (p <0.001). In patients with CVI II and CVI III stage LDF remained nearly unchanged after arterial occlusion (6% increase vs. 342% in healthy subjects and 214% increase in patients with CVI I (p <0.001 vs. p <0.001). Experimental venous hypertension (cuff pressure 70 mmHg) led to profound reduction of flux in all 3 groups (I: –90%; II: –91.7%; III: –91.4%). At the same time, absolute LDF values during experimental venous hypertension (40 and 70 mmHg) were significantly higher in patients with CVI II and III in comparison to patients with CVI I and healthy subjects (p <0.001 vs. p <0.001). Conclusion: It seems that in severe CVI patients the venoarteriolar reflex, despite being comparable in magnitude to that in healthy subjects, may nonetheless be insufficient to reduce LDF during experimental venous hypertension to the level similar to that in healthy subjects and patients with CVI I.

scholarly journals Inflammatory cytokine levels in chronic venous insufficiency ulcer tissue before and after compression therapy

2009 ◽  
Vol 49 (4) ◽  
pp. 1013-1020 ◽  
Author(s):  
Stephanie K. Beidler ◽  
Christelle D. Douillet ◽  
Daniel F. Berndt ◽  
Blair A. Keagy ◽  
Preston B. Rich ◽  
...  
Keyword(s):  
Chronic Venous Insufficiency ◽  
Inflammatory Cytokine ◽  
Venous Insufficiency ◽  
Compression Therapy ◽  
Cytokine Levels ◽  
Before And After

Three Tests of Microcirculatory Function in the Evaluation of Treatment for Chronic Venous Insufficiency

1990 ◽  
Vol 5 (3) ◽  
pp. 165-172 ◽  
Author(s):  
T. R. Cheatle ◽  
G. M. McMullin ◽  
J. Farrah ◽  
P. D. Coleridge Smith ◽  
J. H. Scurr
Keyword(s):  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Subcutaneous Fat ◽  
Intermittent Pneumatic Compression ◽  
Laser Doppler ◽  
Response To Treatment ◽  
Venous Disease ◽  
Doppler Flowmetry ◽  
Xenon Clearance ◽  
Microcirculatory Function

No investigation exists which has been shown to detect accurately microcirculatory improvement following treatment for chronic venous insufficiency. This study examines three possible techniques for doing so. Fourteen patients with chronic venous insufficiency and fourteen controls underwent measurement of transcutaneous PO2, 133xenon clearance from the skin and subcutaneous tissues and laser–Doppler flowmetry in the gaiter region. Patients with venous disease then followed a regime of intermittent pneumatic compression for 4 h each day for 4 weeks. The same measurements were then repeated. Xenon clearance from subcutaneous fat and the time taken to reach maximal laser–Doppler flow after release of a tourniquet showed a significant improvement after compression treatment. These tests may be useful as parameters in the objective monitoring of response to treatment in patients with liposclerotic skin.

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