Authors
Sannikov A.B.
Privolzsky Research Medical University (Vladimir Branch), Vladimir
Abstract
Objectives. The aim of the study was to determine the degree of influence of retrograde blood flow in the deep veins of various segments of the lower extremities on the formation of pathological segmental hypervolemia of the lower leg in patients with chronic venous diseases (CVD) of various clinical classes according to the CEAR classification.
Methods. 380 healthy individuals and 896 patients with CVD were examined using ultrasound scanning (USDS) and pneumoplethysmography (PPG). Retrograde blood flow was detected in the ilio-femoral, femoral-popliteal and popliteal-suric venous segments. The extent of reflux was classified into three degrees. To assess the intensity of venous outflow, the following values were calculated: the maximum capacity of the lower leg veins, the volume of their emptying, the maximum venous outflow, and the ratio of these values on both extremities.
Results. It was found that retrograde blood flow in deep veins lasting more than 3 seconds is important for the progression of chronic venous insufficiency (CVI) in patients with CVD. The most noticeable effect of retrograde blood flow on the progression of CVI is when they are localized at the level of the popliteal and intramuscular veins of the lower leg. At the same time, the pneumoplethysmographic venous capacity index (VCI) has statistically significant differences as CVD progresses, which may indicate that patients develop pathological segmental venous hypervolemia of the lower leg as the disease progresses.
Conclusion. The presence of prolonged popliteal-sural reflux in patients with CVD affects the formation of pathological segmental hypervolemia of the lower leg and is a hemodynamic factor in the development of CVI.
Keywords: chronic venous diseases, noninvasive diagnosis of hemodynamic disorders, venous reflux in deep veins, significance of venous reflux, air plethysmography, pathological segmental venous hypervolemia.
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