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Da Matta ES, Mosti G, Corralo VDS, Moura GPD, Quadros LBD, De Sá CA. Effects of lower limb muscle strengthening on interface pressure in older adults undergoing inelastic compression: Randomized controlled clinical trial. Phlebology 2024; 39:379-387. [PMID: 38369821 DOI: 10.1177/02683555241235042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
OBJECTIVE To analyze the effects of lower limb muscle strengthening on interface pressure (IP), static stiffness index (SSI), dynamic stiffness index (DSI), and walking pressure amplitude (WPA) in older adults undergoing inelastic compression therapy. METHOD Forty-three healthy older adults of both sexes (Age: 66.2 ± 4.4 years) met the eligibility criteria and completed all stages of the study (Resistance Training - RT: N = 20; Control - CONT: N = 23). Body composition, strength and functional mobility of lower limbs, IP, SSI, DSI, and WPA were evaluated before and after intervention. RESULTS The two-way ANOVA with repeated measures demonstrated a significant time-group interaction effect on muscular strength for 1-RM [F (1, 41) = 21.091; p ≤ 0.001], IP in the orthostatic position [F (1, 41) = 5.124; p ≤ 0.05], minimum WPA [F (1, 41) = 10.999; p ≤ 0.05], maximum WPA [F (1, 41) = 8.315; p ≤ 0.05], DSI minimum (F (1, 41) = 4.608; p ≤ 0.05), DSI maximum (F (1, 41) = 8.926; p ≤ 0.05), and on the delta DSI (F (1, 41) = 7.891; p ≤ 0.05). CONCLUSIONS In RT group, the increase in lower limb muscle strength was accompanied by an increase in IP in foot dorsiflexion and plantar flexion maneuvers, both in the standing position (DSI) and during gait (WPA).
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Affiliation(s)
- Eduardo Simões Da Matta
- Postgraduate Program in Health Sciences, School of Health, Universidade Comunitária da Região de Chapecó, Chapecó, Brazil
- Pró-Circulação™ - Angiology and Vascular Surgery Clinic, Xanxerê, Brazil
| | | | - Vanessa da Silva Corralo
- Postgraduate Program in Health Sciences, School of Health, Universidade Comunitária da Região de Chapecó, Chapecó, Brazil
| | | | - Luciano Branco de Quadros
- Pró-Circulação™ - Angiology and Vascular Surgery Clinic, Xanxerê, Brazil
- Life Sciences and Health Area, Universidade Do Oeste de Santa Catarina, Xanxerê, Brazil
| | - Clodoaldo Antônio De Sá
- Postgraduate Program in Health Sciences, School of Health, Universidade Comunitária da Região de Chapecó, Chapecó, Brazil
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Yie K, Jeong EH, Hwang EJ, Shin AR. Stocking-only versus additional eccentric compression after below-the-knee truncal vein sclerotherapy: A SOVAECS prospective randomized within-person trial. J Vasc Surg Venous Lymphat Disord 2023; 11:1122-1129.e3. [PMID: 37536560 DOI: 10.1016/j.jvsv.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/08/2023] [Accepted: 07/20/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE After foam sclerotherapy in the truncal saphenous vein, the clinical effects of additional eccentric compression has not yet been explored. METHODS Between April 2020 and February 2021, we enrolled 42 patients (84 limbs) who underwent bilateral endovenous combined therapy for great saphenous vein (GSV) reflux. Each patient received the same type of endovenous ablation in both above-the-knee GSVs (laser, radiofrequency, cyanoacrylate glue), and combined foam sclerotherapy was performed on both below-the-knee GSVs. Subsequently, we conducted a prospective randomized, single-blind, within-person study in which each patient's bilateral truncal saphenous vein of the calves underwent two different compression therapies: wearing of a regular class II compression stocking on one side (RC group) and additional eccentric compression on the other side (AC group). The primary end point was the occlusion range (score, 0-10) of the below-the-knee truncal GSV after foam sclerotherapy. The secondary outcomes were the pain score (visual analog scale score range, 0-10) of the paired limb, the required number of additional foam sclerotherapy sessions, compliance with compression therapy, and procedure-related complications. RESULTS For the above-the-knee GSV, endovenous laser treatment (n = 44), endovenous radiofrequency ablation (n = 14), and endovenous cyanoacrylate glue ablation (n = 26) were performed. The mean subcompression pressure of the medial calf in the supine and standing positions were 16.7 ± 2.34 mm Hg and 24.5 ± 6.6 mm Hg in the RC group and 38.5 ± 5.5 mm Hg and 45.3 ± 8.2 mm Hg in the AC group, respectively (P = .000). The secondary outcomes of pain score, number of additional foam sclerotherapy sessions, and pigmentation were not significantly different statistically between the two groups. The patient-reported satisfaction scores (range, 0-10) on compression at 24 hours postoperatively were 8.03 ± 1.9 for the AC group and 7.98 ± 1.9 for the RC group (P = .317; Wilcoxon signed ranks test). In both groups, the closure rate of the above-the-knee GSV at 1 month postoperatively was 100%. No procedure-related complications were identified within 1 month postoperatively, including no deep vein thrombosis, numbness, or skin necrosis requiring additional medical attention. CONCLUSIONS The 24 hours of additional eccentric compression on the truncal GSV compared with the use of a conventional knee-level stocking only did not yield any clinical advantages in terms of the occlusion range, postoperative pain, need for additional sclerotherapy, or skin pigmentation after foam sclerotherapy. The decision on which type of compression therapy to perform after foam sclerotherapy in the truncal vein should be comprehensively determined.
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Affiliation(s)
- Kilsoo Yie
- Department of Surgery, College of Medicine, Pusan National University, and Jeju Soo Cardiovascular Center, Jeju, South Korea.
| | - Eun-Hee Jeong
- Department of Surgery, College of Medicine, Pusan National University, and Jeju Soo Cardiovascular Center, Jeju, South Korea
| | - Eun-Jung Hwang
- Department of Surgery, College of Medicine, Pusan National University, and Jeju Soo Cardiovascular Center, Jeju, South Korea
| | - A-Rom Shin
- Department of Surgery, College of Medicine, Pusan National University, and Jeju Soo Cardiovascular Center, Jeju, South Korea
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Jiang T, Song K, Yao Y, Zhuang Z, Shen Y, Li X, Xu Z, Jiang Q. Thigh-length graduated compression stocking cannot increase blood velocity of the common femoral vein in patients awaiting total hip arthroplasty. BMC Musculoskelet Disord 2022; 23:765. [PMID: 35948890 PMCID: PMC9367155 DOI: 10.1186/s12891-022-05737-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/08/2022] [Indexed: 11/10/2022] Open
Abstract
Objectives Graduated compression stocking (GCS) is one of the mechanical prophylaxes commonly used for deep vein thrombosis (DVT). The present study was designed to observe the effects of graduated compression stockings on the vein deformation and hemodynamics of lower limbs in patients awaiting total hip arthroplasty (THA). Methods The lower extremity veins of 22 patients awaiting THA were examined by ultrasound, when they rested in supine position with or without thigh-length GCS. The deformation parameters we measured included antero-posterior (AP) diameters, latero-medial (LM) diameters, and cross-sectional area (CSA) of great saphenous vein (GSV), posterior tibial vein (PTV), popliteal vein (PV), gastrocnemius vein (GV), and superficial femoral vein (SFV). We measured peak velocity and mean velocity of GSV, common femoral vein (CFV), junction of GSV and CFV to represent for hemodynamics of veins. Results Significant compression was observed in almost all measured veins with the use of thigh-length GCS, while it was unable to significantly compress GSV in latero-medial diameter. The mean latero-medial diameter reductions for GSV, PTV, GV, PV and SFV were 19.4, 30.2, 43.2, 29.7 and 20.4%, respectively. GCS significantly compressed antero-posterior diameter of GSV, PTV, GV, PV and SFV by 43.4, 33.3, 42.1, 37.5, and 27.8%, respectively. The mean reduction of cross-section area was 44.8% for GSV, 49.6% for PTV, 60.0% for GV, 57.4% for PV, and 36.2% for FV. No significant changes were observed in the mean blood velocity of GSV, CFV, and junction. GCS was able to significantly reduce peak velocity of CFV (17.6 ± 5.6 cm/s to 16.1 ± 6.0 cm/s) and junction (23.3 ± 9.5 cm/s to 21.3 ± 9.7 cm/s), while it did not change the peak velocity of GSV. Conclusion Thigh-length GCS is sufficient to compress lower extremity veins in patients awaiting THA in supine position with the greatest compression in GV, while it was unable to significantly increase blood velocity of common femoral vein or GSV. GCS may prevent DVT through more than simply increasing blood flow. Further studies are needed to determine the specific effects of GCS.
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Affiliation(s)
- Tao Jiang
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 210008, Nanjing, People's Republic of China
| | - Kai Song
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 210008, Nanjing, People's Republic of China.,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Yao Yao
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 210008, Nanjing, People's Republic of China.,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Zaikai Zhuang
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 210008, Nanjing, People's Republic of China.,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Ying Shen
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 210008, Nanjing, People's Republic of China.,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Xinhua Li
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 210008, Nanjing, People's Republic of China.,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Zhihong Xu
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 210008, Nanjing, People's Republic of China. .,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China.
| | - Qing Jiang
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 210008, Nanjing, People's Republic of China. .,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China.
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Zhuang Z, Wang Y, Yao Y, Shen Y, Chen D, Jiang Q. The impact of graduated compression stockings on calf-vein deformation and blood velocity in patients awaiting total knee arthroplasty. BMC Musculoskelet Disord 2021; 22:722. [PMID: 34425810 PMCID: PMC8381553 DOI: 10.1186/s12891-021-04603-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 08/09/2021] [Indexed: 02/02/2023] Open
Abstract
Objectives This study was designed to explore venous deformation of the lower extremities and the changes in venous hemodynamics in supine position before and after wearing graduated elastic stockings in patients awaiting total knee arthroplasty (TKA). Method The leg veins of 21 elderly patients awaiting TKA were imaged in the supine position with and without knee-length graduated compression stockings (GCS) according to a fixed protocol. Measured parameters including the lateromedial (LM) diameter, anteroposterior (AP) diameter, and cross-sectional area (CSA) of the great saphenous vein (GSV), gastrocnemius vein (GV), soleus vein (SV), posterior tibial vein (PTV), fibular vein (FV), and anterior tibial vein (ATV). In addition, the mean and maximum velocities of the popliteal vein (PV) and superficial femoral vein (FSV) were measured. Results GCS-related compression was observed for all the measured veins. Maximal reduction was observed for the GV and SV, whereas the GSV exhibited the lowest degree of GCS-related compression. The mean cross-sectional area reduction values associated with GCS were 33.1 ± 41.2 % for the GSV, 94.8 ± 11.1 % for the GV, and 85.6 ± 20.3 % for the SV, while the mean reduction of anteroposterior diameter was 18.1 ± 34.5 % for the GSV, 89.0 ± 22.5 % for the GV, and 72.9 ± 35.1 % for the SV, and the mean reduction of the lateromedial diameter was 25.9 ± 36.4 % for the GSV, 89.6 ± 19.6 % for the GV, 78.2 ± 28.3 % for the SV. No significant GCS-related changes in blood velocity in the superficial femoral veins or popliteal veins were detected. Conclusions For elderly patients awaiting TKA, knee-length GCS can significantly reduce calf vein dilation while at rest in the supine position, with the greatest reductions being observed for the soleus and gastrocnemius veins. These data might help provide a theoretical basis for the GCS in reducing incidence of deep vein thrombosis in patients undergoing TKA.
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Affiliation(s)
- Zaikai Zhuang
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, 210008, People's Republic of China
| | - Yexian Wang
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, 210008, People's Republic of China.,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Yao Yao
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, 210008, People's Republic of China.,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Ying Shen
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, 210008, People's Republic of China.,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Dongyang Chen
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, 210008, People's Republic of China. .,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China.
| | - Qing Jiang
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, 210008, People's Republic of China. .,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China.
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5
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Mestre S, Triboulet J, Demattei C, Veye F, Nou M, Pérez-Martin A, Dauzat M, Quéré I. Acute effects of graduated and progressive compression stockings on leg vein cross-sectional area and viscoelasticity in patients with chronic venous disease. J Vasc Surg Venous Lymphat Disord 2021; 10:186-195.e25. [PMID: 33964512 DOI: 10.1016/j.jvsv.2021.03.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/05/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine the effects of graduated and progressive elastic compression stockings (ECS) on postural diameter changes and viscoelasticity of leg veins in healthy controls and in limbs with chronic venous disease (CVD). METHODS In 57 patients whose legs presented with C1S, C3, or C5 CEAP classes of CVD and treated primarily with compression, and 54 healthy controls matched for age and body mass index, we recorded interface pressures at 9 reference leg levels. Cross-sectional areas of the small saphenous vein (SSV) and a deep calf vein (DCV) were measured with B-mode ultrasound with subjects supine and standing, recording the force (PF) applied on the ultrasound probe to collapse each vein with progressive ECS, and with and without graduated 15‒20 mmHg and 20‒36 mmHg elastic stockings. We chose these veins because they were free of detectable lesion and could be investigated at the same level (mid-height of the calf), while their compression by the ultrasound probe was not hampered by bone structures. RESULTS Interface pressures decreased from ankle to knee with graduated 15‒20 and 20‒36 mmHg, but increased with progressive ECS, and were 8.4‒13.8 mmHg lower for C1s than for control or C3 and C5 limbs. Without ECS, SSV median [lower‒upper quartile] cross-sectional area was 4.9[3.6‒7.1] and 7.1[3.0‒9.9]mm2 in C3 and C5 limbs vs. 2.9[1.8‒5.2] and 3.8[2.1‒5.4]mm2 in controls (p<.01), respectively while supine and standing. It remained greater in C3 and C5 than in C1S and control limbs wearing any ESC. Wearing compression, especially with progressive ECS, decreased SSV and DCV cross-sectional area only with subjects supine, thus lowering postural changes which remained highly diverse between individuals. The SSV cross-sectional area vs. PF function traced a hysteresis loop of which the area, related to viscosity, was greater in C3 and C5 limbs than controls, even with graduated 15‒20 or 20‒36 mmHg ECS. Progressive ECS lowered vein viscosity in the supine position whereas 20‒36 mm Hg and progressive ECS increased distensibility in the standing position. CONCLUSION Elastic compression stockings reduce cross-sectional area of superficial and deep calf veins with patients supine but not upright. C1s limbs show distinctive features, especially regarding interface pressures. Graduated 20‒36 mm Hg and progressive stockings lower viscosity and increase distensibility of the small saphenous vein.
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Affiliation(s)
- Sandrine Mestre
- Department of Vascular Medicine, Montpellier University, Montpellier, France; EA2992, Montpellier University, Montpellier, France.
| | | | | | - Florent Veye
- LIRMM, Montpellier University, Montpellier, France
| | - Monira Nou
- Department of Vascular Medicine, Montpellier University, Montpellier, France
| | - Antonia Pérez-Martin
- EA2992, Montpellier University, Montpellier, France; Department of Vascular Medicine, Nimes University Hospital, Numbes, France
| | - Michel Dauzat
- EA2992, Montpellier University, Montpellier, France; Department of Vascular Medicine, Nimes University Hospital, Numbes, France
| | - Isabelle Quéré
- Department of Vascular Medicine, Montpellier University, Montpellier, France; EA2992, Montpellier University, Montpellier, France
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Venous reflux in the great saphenous vein is driven by a suction force provided by the calf muscle pump in the compression-decompression maneuver. J Vasc Surg Venous Lymphat Disord 2020; 9:1282-1290. [PMID: 33338642 DOI: 10.1016/j.jvsv.2020.12.070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 12/05/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The gravitational pressure gradient is considered the driving force of venous reflux. The results from our previous study demonstrated that gravitational force is not a necessary condition for the occurrence of venous reflux. We hypothesized that a force exists in addition to gravity that drives venous reflux. The present study was designed to test this hypothesis by measuring the acceleration of blood flow during venous reflux in a clinical study and by simulating reflux ex vivo in physical models. METHODS A total of 80 lower extremities of 80 patients with primary incompetence of the great saphenous vein were included in the present study. The cross-sectional area of the great saphenous vein, peak velocity of venous reflux (PV), and time required to achieve the PV (Δt, seconds) were measured on duplex ultrasound scans taken with the patient in the standing rest position. Noncycling operator-dependent distal cuff inflation-deflation was used as the reflux provoking maneuver. The acceleration of venous reflux (areflux) was calculated as areflux = PV/Δt in m/s2. Physical models were used to demonstrate the difference in acceleration between the free-fall stream and the flow forced by suction. RESULTS The magnitude of areflux was greater than gravity in 24 of 80 extremities (30%), with a range of 9.83 to 24.13 m/s2. The maximum observed value of areflux was approximately 2.5g (24.13 m/s2). The areflux weakly, but statistically significant inversely, correlated with the subject height (r = -0.26; P = .001). The difference in water flow acceleration was 2.5 times between the free-fall model and suction model (9.07 ± 0.2 m/s2 vs 23.32 ± 2.6 m/s2, respectively). CONCLUSIONS The acceleration of blood flow during reflux exceeded the value of gravitational acceleration, suggesting the action of an additional nongravitational force. The calf muscle pump might create such force by negative pressure during muscle diastole.
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Karafa M, Karafova A. Kikuhime Device in the Management of Venous Leg Ulcers. Clin Interv Aging 2020; 15:1533-1539. [PMID: 32943856 PMCID: PMC7478371 DOI: 10.2147/cia.s264567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/07/2020] [Indexed: 11/23/2022] Open
Abstract
The effectiveness of compression therapy in the treatment of venous leg ulcers has been confirmed in many scientific studies. The healing process depends on many of its parameters, such as the type of compression bandages, their elastic properties and sub-bandage pressure. However, there is no standard protocol that would ensure success for all patients. A pressure of about 83 mmHg provides complete compression for both superficial and deep veins; however, applying compression bandages under such high pressure is a difficult task, even for experienced therapists. Here, we present the case of a 61-year-old woman with approximately 2.5-year-old venous ulcer in her left leg due to chronic venous insufficiency (CVI). Our study aimed to show that routine pressure control at each bandage renewal using the Kikuhime device, as well as their twice daily application in the first week of therapy reduced the healing time of a venous leg ulcer with an area of about 20 cm2 to four weeks.
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Affiliation(s)
- Marian Karafa
- Faculty of Physical Education, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Anna Karafova
- Faculty of Physical Education, Gdansk University of Physical Education and Sport, Gdansk, Poland
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Benigni JP, Uhl JF, Chahim M. Effects of compression stockings and leg positions on the caliber of the reticular veins. INT ANGIOL 2019; 38:425-426. [PMID: 31355593 DOI: 10.23736/s0392-9590.19.04198-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Jean-Patrick Benigni
- French University Group for Medical Compression Study, Paris Descartes University, Paris, France -
| | - Jean-François Uhl
- French University Group for Medical Compression Study, Paris Descartes University, Paris, France.,Urdia Research Unit, Paris Descartes University, Paris, France
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9
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Lower limb volume in healthy individuals after walking with compression stockings. J Vasc Surg Venous Lymphat Disord 2019; 7:557-561. [DOI: 10.1016/j.jvsv.2019.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 02/02/2019] [Indexed: 11/19/2022]
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10
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Rastel D, Lun B. Response to “Re. Lower Limb Deep Vein Diameters Beneath Medical Compression Stockings in the Standing Position”. Eur J Vasc Endovasc Surg 2019; 57:891-892. [DOI: 10.1016/j.ejvs.2019.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 02/22/2019] [Indexed: 11/29/2022]
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Partsch H, Mosti G. Paradox Findings are Reality, Difficult is the Explanation. Eur J Vasc Endovasc Surg 2019; 57:891. [PMID: 30910495 DOI: 10.1016/j.ejvs.2019.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 01/30/2019] [Indexed: 10/27/2022]
Affiliation(s)
| | - Giovanni Mosti
- Angiology Department, Barbantini Hospital, Lucca, Italy.
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12
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Yang A, Yasaman B, Parsi Y, Kang M, Connor D, Parsi K. Two layers of graduated compression stockings can reduce healthy saphenous vein diameters in the standing position. Phlebology 2019; 34:559-565. [PMID: 30739568 DOI: 10.1177/0268355519828871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Previous studies reported graduated compression stockings can reduce the calibre of deep veins in the standing subjects. However, the literature has been inconclusive on the effect of graduated compression stockings on superficial veins in standing subjects. Objectives To assess the effect of two layers of graduated compression stockings on the diameter of saphenous veins in healthy subjects. Materials and methods In 17 legs of nine healthy subjects, we studied the effect of single layering and double layering of graduated compression stockings (23–32 mmHg, Thigh High Belted Sigvaris, Switzerland) on the diameter of the great saphenous vein mid-thigh, great saphenous vein mid-calf and small saphenous vein mid-calf. The measurements were taken using duplex ultrasound (Toshiba Aplio XG 500, 18-7 MHz transducer), through the fabric using a generous amount of ultrasound gel, on subjects both supine or prone and standing. Results Two layers of Class II graduated compression stockings reduced the calibre of great saphenous vein mid-thigh from (4.1 mm to 3.3 mm, p < 0.05), great saphenous vein mid-calf (2.8 mm to 2.2 mm, p < 0.01) and small saphenous vein (2.7 mm to 1.9 mm, p < 0.01) in the standing position. In the supine or prone position, great saphenous vein showed narrowing but there was no measurable change in the calibre of the small saphenous vein. The degree of narrowing was measurable, but insufficient to approximate the vein walls. Conclusion Superimposition of two Class II graduated compression stockings reduced the calibre of the saphenous veins in the standing position but did not approximate the vein walls. In the supine or prone position, the addition of a second layer of graduated compression stockings did not result in further narrowing of the saphenous veins.
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Affiliation(s)
- Anes Yang
- 1 Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St Vincent's Centre for Applied Medical Research, Darlinghurst, Australia.,2 Department of Dermatology, St Vincent's Hospital, Darlinghurst, Australia
| | | | - Yana Parsi
- 3 Sydney Skin and Vein Clinic, Chatswood, Australia
| | - Mina Kang
- 4 Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - David Connor
- 1 Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St Vincent's Centre for Applied Medical Research, Darlinghurst, Australia
| | - Kurosh Parsi
- 1 Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St Vincent's Centre for Applied Medical Research, Darlinghurst, Australia.,2 Department of Dermatology, St Vincent's Hospital, Darlinghurst, Australia.,3 Sydney Skin and Vein Clinic, Chatswood, Australia.,4 Faculty of Medicine, University of New South Wales, Sydney, Australia
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Lower Limb Deep Vein Diameters Beneath Medical Compression Stockings in the Standing Position. Eur J Vasc Endovasc Surg 2018; 57:276-282. [PMID: 30236442 DOI: 10.1016/j.ejvs.2018.07.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 07/31/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The mechanism by which compression therapy works is still discussed, especially at calf level. Whether lower limb deep vein diameters change under compression stockings is a matter of debate: no change versus great change. New study material helps to address this question. METHODS This was an experimental single centre controlled study on nine selected patients with mild to moderate superficial venous disease. A total of 34 deep vein segments were examined. A new hybrid (elastic + non-elastic materials) cuff pressure device enabled the deep vein diameter changes from baseline to occlusion similar to that which could be observed under stockings. The deep vein diameters were measured through the device with the patients in a standing position and their body weight distributed equally on both legs. This was compared to a 20-35 mm Hg medical compression stocking. The diameter change when patients put their whole body weight on the tested leg was also measured. RESULTS A pressure of 25.3 ± 6.4 mm Hg (mean, SD) was required to ovalise lower leg deep veins and a pressure of 43.1 ± 16.2 mm Hg (mean, SD) to occlude them. Both pressures were significantly different from baseline: p = .003 and p < .0001, respectively. No diameter reduction was achieved when the stockings were worn, and occlusion of deep veins occurred when the patients transferred their body weight onto the examined leg. CONCLUSION In the standing position, deep vein diameter reduction is not caused by compression stockings but may be due to the isometric muscle contractions required to support the patient's body weight.
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The Compression Paradox of Deep Veins May Not be a Paradox. Eur J Vasc Endovasc Surg 2018; 57:283. [PMID: 30177413 DOI: 10.1016/j.ejvs.2018.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 08/12/2018] [Indexed: 11/20/2022]
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Mosti G, Partsch H, Schuren J. Letters — Letter to Kravitz et al. on methods for studying the pressure applied by compression fabrics. J Wound Care 2016; 25:S24-6. [DOI: 10.12968/jowc.2016.25.sup4.s24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Hugo Partsch
- Professor Emeritus Medical University of Vienna, Austria
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Partsch H, Mortimer P. Compression for leg wounds. Br J Dermatol 2015; 173:359-69. [DOI: 10.1111/bjd.13851] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2015] [Indexed: 11/29/2022]
Affiliation(s)
- H. Partsch
- Department of Dermatology Medical University of Vienna Vienna Austria
| | - P. Mortimer
- Department of Dermatology St George's Hospital University of London London U.K
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