A Methodological Study of Venous Valvular Insufficiency and Musculovenous Pump Function of the Lower Leg

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Abstract
Objective: To assess venous valvular function of the lower limb using Duplex scanning and descending phlebography, and compare the results obtained with clinical examination and other methods of monitoring venous function of the lower limb, including venous photoplethysmography, strain-gauge phlethysmography, foot volumetry and intramuscular pressure readings. Design: Non-randomised, retrospective study of patients referred for investigation of venous disease. Patients investigated included a group of 20 who had previously undergone fasciotomy of the lower limb, and a group of healthy controls. Setting: Patients referred to St Goran's Hospital, Stockholm, Sweden. Intervention: Venous photoplethysmography, foot volumetry, strain-gauge plethysmography, photoplethysmography, Dopplex/Duplex ultrasound, phlebography, intravenous pressure and intramuscular pressure readings in various sub-groups. Main outcome measures: Determination of sites of venous reflux in the lower limb using Duplex/Doppler and phlebography, and correlation of the results obtained with other methods of investigation of lower limb venous function. Results: Poor correlation was found between descending phlebography and Duplex scanning, although good correlation was found between the number of segments with reflux and clinical condition. PPG recovery time was very variable, depending on transducer position, numbers of dorsiflexions performed, and reflux in superficial veins.

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