Correlation of central venous pressure with Doppler waveform of the common femoral veins.

Cozcolluela, María Rosa; Sarría, Luis; Sanz, Luis Marcano; Martínez-Berganza, M T; Vera, J.; Bernal, Alejandra Gutierrez; García, Santiago López

doi:10.7863/jum.2000.19.8.587

Cited by 11 publications

(10 citation statements)

References 8 publications

(16 reference statements)

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“…A similar study by Cozcolluela et al 11 looked at 236 patients and demonstrated a “significant inverse relation…. between pulsatile flow and high atrium pressure.” However, low sensitivity again precluded any recommendation as a screening tool for elevated central venous pressure.…”

Section: Discussionmentioning

confidence: 79%

Does Distal Venous Hypertension Affect Lower-Extremity Venous Pulsatility?

Schroedter¹,

White²,

White³

et al. 2011

Journal for Vascular Ultrasound

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Introduction Pulsatile flow in the lower-extremity venous system is commonly attributed to various cardiac abnormalities. In patients with significant venous insufficiency and resultant venous hypertension, venous capacitance may be drastically reduced. We have noted multiple patterns of venous pulsatility and theorized that the hemodynamic state of the lower-extremity venous system could in fact play a role in these patterns. If venous reflux is isolated to the superficial system, ablation of these veins could resolve the venous hypertension and potentially influence the pulsatile flow pattern. Methods We compared the presence and pattern of lower extremity venous pulsatility in 293 consecutive patients suffering from chronic venous insufficiency (Mean CEAP 3.2). Of these, 242 limbs underwent endovenous thermal ablation (EVTA) of a refluxing truncal vein. Duplex ultrasound was used to evaluate these limbs approximately 3 days post procedure and the results of 101 limbs were available for comparison with the initial exam and provide the basis of this study. Results Of the 101 limbs, 47 (46.5%) had evidence of pulsatile flow in the lower extremity venous system preoperatively which was graded into one of three categories. Forty-eight (47.5%) had deep venous insufficiency of either the femoral vein (n = 16) or popliteal vein (n = 32), which was graded as normal, >1 second, or >2 seconds. The remaining had no evidence of deep vein reflux. Paired observations using the Wilcoxon method showed no difference in the venous pulsatility post ablation. Additionally, isolating patients with no evidence of deep venous reflux also revealed no difference in pulsatility following ablation. Conclusion Ablation of refluxing truncal veins did not appear to influence the presence or pattern of venous pulsatility in the lower extremities regardless of deep system valve function.

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Section: Discussionmentioning

confidence: 79%

Does Distal Venous Hypertension Affect Lower-Extremity Venous Pulsatility?

Schroedter¹,

White²,

White³

et al. 2011

Journal for Vascular Ultrasound

View full text Add to dashboard Cite

show abstract

“…A follow-up study to this one found that when considered with evidence of “cardiac decompensation” on two consecutive chest radiographs, sensitivity increased to 79%. 16 In a similar study, Cozcolluela et al 17 looked at 236 patients and demonstrated a “significant inverse relation…. between pulsatile flow and high atrium pressure.” However, low sensitivity again precluded any recommendation as a screening tool for increased central venous pressure.…”

Section: Discussionmentioning

confidence: 93%

Presence of Lower-Extremity Venous Pulsatility is not always the Result of Cardiac Dysfunction

Schroedter¹,

White²,

García³

et al. 2014

Journal for Vascular Ultrasound

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Introduction The presence of peripheral venous pulsatility is widely recognized and commonly attributed to cardiac dysfunction; however, the precise cause(s) have been poorly defined in the literature. We have noted multiple patterns of venous pulsatility, often in patients with no history of heart disease. In a normal, high compliance venous system, cardiac pulsatility is continually dampened with distance from the heart. We theorized that in a low-compliance system, the pulsatility would be transmitted throughout and its presence is a reflection of the hemodynamic state of the lower extremity venous system. Methods We evaluated the right popliteal vein in 30 normal volunteers (average age 35) with no history of heart disease and minimal venous disease (C-Class range 0–2, average 0.4). The right popliteal vein was chosen for its distal anatomic location and to avoid any potential of left iliac vein compression. Three spectral waveforms were obtained in the following manner: (1) a left lateral supine position with the right popliteal vein at the level of the right atrium, (2) after standing for >3″ with no right leg weight bearing or muscle contraction, and (3) after 10 seconds of vigorous plantar/dorsiflexion. Results In a supine position, all 30 limbs had normal respiratory phasicity with minor variation. In every patient, after quiet standing there was very low velocity forward flow with a discernable pulsatility. Immediately after dorsiflexion, flow became highly pulsatile. Conclusion A total of 100% of patients demonstrated highly pulsatile flow when the lower extremity venous system was filled to resting hydrostatic pressure. Although cardiac dysfunction may result in venous hypertension, reducing system compliance, the presence of pulsatile venous flow in the lower extremity can be demonstrated in all persons and is therefore a function of venous hemodynamics.

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“…The largest study in which right heart catheterization and 236 CFV Doppler interrogations were performed showed a prevalence of 31% of pulsatile CFV Doppler signals. A significant correlation between the right atrial pressure and the CFV pulsatility index (PI) ([maximal–minimal velocity]/mean velocity) was reported ( 28 ). Alimoğlu et al ( 29 ) observed that the mean PI in patients with elevated right atrial pressure (7.75 ± 3.19) was significantly higher than in patients with normal right atrial pressure (1.55 ± 1.30; p < 0.001).…”

Section: Discussionmentioning

confidence: 99%

“…The CFV is located inferior to the ileo-inguinal ligament and medial to the common femoral artery. Care should be taken to correctly identify the CFV and not one of its tributaries, such as the saphenous vein ( 27 , 28 ).…”

Section: How To Perform a Doppler Examination Of The Common Femoral Vmentioning

confidence: 99%

Doppler Interrogation of the Femoral Vein in the Critically Ill Patient: The Fastest Potential Acoustic Window to Diagnose Right Ventricular Dysfunction?

Denault

Aldred

Hammoud

et al. 2020

Critical Care Explorations

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Correlation of central venous pressure with Doppler waveform of the common femoral veins.

Cited by 11 publications

References 8 publications

Does Distal Venous Hypertension Affect Lower-Extremity Venous Pulsatility?

Does Distal Venous Hypertension Affect Lower-Extremity Venous Pulsatility?

Presence of Lower-Extremity Venous Pulsatility is not always the Result of Cardiac Dysfunction

Doppler Interrogation of the Femoral Vein in the Critically Ill Patient: The Fastest Potential Acoustic Window to Diagnose Right Ventricular Dysfunction?

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