The Value of Doppler Venous Pressure Index in Chronic Venous Disease of the Lower Limbs

Abstract

Background: The diagnostic evaluation of chronic venous disease (CVD) of the lower limbs (LLs) is mainly based on duplex ultrasound (DUS). Invasive venous pressure measurements (VPMs) are seldom performed in specialized centers with still controversial results. The noninvasive Doppler method has not been accepted as a validate method as the emerging values are influenced by several environmental and biological factors, and do not correspond to hydrostatic pressure. Therefore, these values will be defined as venous pressure index (VPI). In our previous experience, the VPI was accepted by patients in the daily practice, and the VPI was significantly correlated with C of C.E.A.P. (P < 0.05 -0.0001) and furnished useful hemodynamic information. This study was to verify the role and clinical implications of the VPI measurements in the pathophysiology and diagnostics of superficial CVD of the LL.

Elastic compression treatment of chronic superficial venous insufficiency of the lower limbs based on Doppler venous pressure index measurements

“…The R was considered pathological when the time of duration was more than 1 second. [19][20][21] In 1212 LL of 887 patients with CVI and 162 free from CVI, which were observed in our vascular laboratory by DUS examination, the VPI measurements were systematically performed. Limbs affected with venous malformations, deep venous thrombosis, superficial phlebitis were excluded.…”

“…The VPI were detected by Doppler method (Dop 2.000 ® ; Cardioline Milano, Italy) in standing position and after 10 tip-toeing exercises (ambulatory VPI) and the differential values were calculated. 14,15,19 Patients affected with deep venous insufficiency were also examined in the same period and by the same investigations, but owing to the small number they were not included in the study. The distribution of the cases is reported in Table 1.…”

“…Since 1996 we introduced into our Vascular Laboratory the use of a new phlebologic software for the informatic filing of all the cases studied which has been presented in 1999. 19 The emerging data and the experience acquired clearly demonstrated that the VPI measurements can give useful information concerning the severity of CVI, it is pathophysiology and the therapeutic implications. During our experience we applied the above-mentioned principles for the choice of the GES for the ECT of CVI and/or VVLL and we observed a relevant decrease of unsatisfied patients.…”

Causes and Treatment of Varicose Recurrence in the Popliteal Region

“…Neovascularization by neoangiogenesis is a physiological process following traumas, wounds, hematomas and thrombosis; therefore, it must not be surprising to find it in the thickness of the postoperative scar tissue [1,2]. On the other hand, the natural history of varicose evolution and disease progression can fully explain the appearance of new proximal and/or peripheral varices, as often happens in the primary disease [5,19,22,25].…”

“…In five operated limbs (26.3%), a postoperative foam sclerotherapy and compression were performed after 2 months (Table 3). The compression class of the elastic stockings applied after surgery, sclerotherapy or in combination with drug therapy, was chosen on the basis of noinvasive venous pressure measurements [19,20].…”