Distal Strain Gauge Plethysmography with Selective Superficial Occlusion in Patients with Lower Limb Venous Incompetence and/or Obstruction – A Pilot Study

Johan Skoog1*, Oskar Nelzén2, Margareta Ahle3 and Helene Zachrisson1

1Department of Clinical Physiology and Department of Health, Medicine and Caring Sciences, Linköping University, Sweden
2Department of Thoracic and Vascular Surgery and Department of Health, Medicine and Caring Sciences, Linköping University, Sweden
3Department of Radiology and Department of Health, Medicine and Caring Sciences, Linköping University, Sweden

^*Correspondance to: Johan Skoog 

 PDF  Full Text DOI: 10.25107/2474-1647.3388

Abstract

Background: Quantitative evaluation of venous function is important. The aim of this study was to assess if distal Strain Gauge Plethysmography (SGP) with superficial occlusion is able to quantify the hemodynamic importance of the superficial reflux component in patients with chronic venous disease. Design and Methods: Twelve patients (fourteen limbs) with chronic venous disease were examined with Duplex Ultrasound (DUS), SGP and radiological imaging. SGP was also performed in eleven controls. SGP was used to measure refilling times (T50 and T90, sec). A change in T50 >5 sec between SGP with and without occlusion of superficial veins was used to indicate a significant improvement. Results: No significant improvements in T50 were seen in controls after superficial occlusion, and the median (min-max) change was -2 (-5–4) sec. DUS evaluation in patients displayed five limbs with superficial venous incompetence, one with deep incompetence, three with mixed incompetence, and five with no venous incompetence. Patients with superficial incompetence demonstrated greater improvements in T50 after superficial occlusion compared to controls (p=0.003). In patients with deep and mixed incompetence, no significant improvements in refilling times were seen after superficial occlusion (T50, median (min-max), 3 (1-3) sec). In patients with no detected incompetence, no consistent improvement in T50 and T90 were identified after occlusion, and imaging revealed venous obstruction in four limbs and varicose pelvic/ovarian veins in one limb. Conclusion: Distal SGP with superficial occlusion seems to have the potential to quantify the superficial component of reflux in relation to deep venous reflux or venous obstruction.

Keywords

Venous incompetence; Venous obstruction; Strain-gauge plethysmography Duplex ultrasound; Chronic venous disease

Cite the article

Skoog J, Nelzén O, Ahle M, Zachrisson H. Distal Strain Gauge Plethysmography with Selective Superficial Occlusion in Patients with Lower Limb Venous Incompetence and/or Obstruction – A Pilot Study. Clin Surg. 2021; 6: 3388..