Foot Venous Pressure Measurement in Patients with Varicose Veins

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Abstract
For the evaluation of the severity of varicose veins, foot venous pressure (FVP) measurements utilizing manual calf compression were applied to 52 limbs with varicose veins (group V) and 12 limbs of healthy volunteers (group C). Group V was divided into three groups: group V1 comprising 37 limbs without stasis syndrome, group V2 comprising 9 limbs with pigmentation, and group V3 comprising 6 limbs with preulcerative or ulcerative skin change. First, comparison of manual calf compression with the toe-stand test was performed, wherein a higher reproducibility was revealed for subjects undergoing manual calf compression. Also, a lower ambulatory venous pressure (AVP) and a higher percentage of FVP drop (%drop = [pressure at rest-AVP]/pressure at rest) was obtained with manual calf compression, confirming that this method apparently emptied the calf venous pool. Based on these findings, FVP at four seconds after compression (4SP) and its ratio of increase (4SR% = [4SP - AVP] / [pressure at rest - AVP]) were instituted by use of this method, in addition to AVP, % drop, and 50%/90% of calf-refilling times (RT50/RT90). When the values of the four groups were compared, differences were insignificant between groups C and V1, while significant differences were found between groups V2 (continued on next page) (Abstract continued) or V3 and groups C or V1 in all parameters examined. The number of abnormal limbs that had values beyond the ranges for group C increased from group V1 to group V3. Such abnormalities were best revealed by 4SR% and RT50. In the postoperative FVP measurements of 17 limbs, all parameters of all limbs were restored to the normal range, except for % drop of 4 limbs, and 4SR%, RT50, and RT90 of 1 limb. Based on these findings, all parameters examined in this study were considered to be sufficient for the evaluation of the severity of varicose veins. In particular, 4SR% and RT50, which reflect venous reflux in the early venous refilling phase, were the best diagnostic parameters. The usefulness of FVP measurement utilizing manual calf compression and the significance of the early phase of venous refilling in the varicose veins limbs were confirmed.