Objective: This study investigated the relationship between the ejected blood volume from the calf venous reservoir and the reflux volume (RV) during the automatic cuff inflation-deflation maneuver in limbs with incompetent great saphenous vein.
Methods: There were 48 patients with chronic venous disease (C1-5, Ер, Аs, Pr2,3) included in the study. A noncycling operator-dependent distal cuff inflation-deflation was used as the reflux-provoking maneuver. Duplex ultrasound was used to measure the cross-sectional area of the common femoral vein and great saphenous vein as well as hemodynamic parameters (time-averaged mean velocity and flow duration) of the outflow during cuff inflation and reflux during cuff deflation. The cuff pressure was set at 60, 90, and 120 mm Hg sequentially. The RV flow rate (Q), RV, anterograde ejection volume (EV), and ratio RV/EV (reflux index, IR) were calculated for each pressure setting.
Results: RV correlated with EV and Qreflux (r2 = 0.366 and r2 = 0.647, respectively; P < .0001). Qreflux was not significantly different between different cuff inflation pressures. RV and EV were statistically different at different cuff pressure settings (analysis of variance, P < .0001). The IR was almost identical at different pressure settings (0.43 ± 0.23 at 60 mm Hg, 0.43 ± 0.20 at 90 mm Hg, and 0.42 ± 0.19 at 120 mm Hg).
Conclusions: The amount of reflux is primarily determined by the value of EV in a distal cuff compression-decompression maneuver. Both the ratio RV/EV (IR) and RV were related to the severity of the disease, more severe forms having larger IR and RV values.
Keywords: Calf muscle pump; Duplex ultrasound; Ejection volume; Reflux volume; Varicose veins; Venous reflux.
Copyright © 2020 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.