scholarly journals Validation of the Supine Venous Pump Function Test: A New Non-Invasive Tool in the Assessment of Deep Venous Insufficiency

1996 ◽  
Vol 91 (4) ◽  
pp. 483-488 ◽  
Author(s):  
M. C. H. Janssen ◽  
J. A. H. R. Claassen ◽  
W. N. J. C. Van Asten ◽  
H. Wollersheim ◽  
M. J. M. De Rooij ◽  
...  
Keyword(s):  
Venous Insufficiency ◽  
Normal Values ◽  
Venous Pressure ◽  
Calf Muscle ◽  
Pressure Measurements ◽  
Limits Of Agreement ◽  
Pump Function ◽  
Non Invasive ◽  
Calf Muscle Pump ◽  
Function Test

1. A new non-invasive test was developed to assess calf muscle pump function: the supine venous pump function test. The technique uses strain-gauge plethysmography and is performed in the supine position. The method is superior to other non-invasive methods because basically the most essential haemodynamic parameter, venous pressure decrease, is used by properly converting venous volume measurements into venous pressure. The validity of this test was established by comparison with invasive venous pressure measurements and by determining the reproducibility. Additionally, normal values were determined. 2. In 28 extremities the supine venous pump function test was performed simultaneously with invasive venous pressure measurements. The reproducibility of the test was assessed in 10 randomly chosen volunteers. In 34 volunteers normal values were obtained and 26 patients with clinical venous insufficiency were examined. 3. Comparison of the two methods revealed a correlation coefficient of r = 0.98 (P < 0.001). A mean difference of 3.9%pf between both methods was found with limits of agreement of − 6.3%pf to 14.1%pf. The coefficient of repeatability was 13%pf and the coefficient of variation was 9%. The normal range was found to be >60%pf. The mean pump function in the patient group was 45%pf. 4. The limits of agreement are small enough to be confident that the supine venous pump function test can be used instead of invasive venous pressure measurements to assess calf muscle pump function in clinical practice. The reproducibility of the test is good.

Quantitative Evaluation of Calf Muscle Pump Function after Deep Vein Thrombosis by Non-Invasive Venous Tests

1990 ◽  
Vol 5 (1) ◽  
pp. 51-59 ◽  
Author(s):  
S. Ohgi ◽  
K. Tanaka ◽  
T. Araki ◽  
K. Ito ◽  
H. Hara ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Quantitative Evaluation ◽  
Calf Muscle ◽  
Lower Limbs ◽  
Pump Function ◽  
Muscle Pump ◽  
Vein Thrombosis ◽  
Non Invasive ◽  
Calf Muscle Pump ◽  
Deep Vein

In order to quantitatively evaluate calf muscle pump function following deep vein thrombosis (DVT), expelled volume was investigated by strain gauge plethysmography (SPG). Thirty-six patients with 43 diseased lower limbs and nine healthy persons with 16 control limbs were studied. Of 43 diseased limbs, 20 symptomatic limbs were distinguished from 23 asymptomatic limbs by the presence of heaviness or aching. The following ***noninvasive parameters for the quantitative evaluation of calf muscle pump function, venous refilling time (VRT), venous outflow (VO), venous return (VR), and expelled volume (EV) were measured by SPG or photoplethysmography (DPG). Ambulatory venous pressure (AVP) was taken to represent the standard for calf muscle pump function. Using SPG, the EV, VR, and VRTs distinguished three groups (control, asymptomatic and symptomatic). Among seven indicators (EV, VR, VO, VRTs), EV had the highest correlation coefficient with the AVP ( r = +0.728). A positive EV was present in 85% of the symptomatic limbs, but in only 4% of the asymptomatic limbs. It is concluded that the EV is a useful non-invasive indicator for the quantitative evaluation of calf muscle pump function after deep vein thrombosis.

Comparison of Three Exercises for Evaluation of the Calf Muscle Pump

1995 ◽  
Vol 10 (1) ◽  
pp. 23-27 ◽  
Author(s):  
S. Ohgi ◽  
K. Tanaka ◽  
T. Maeda ◽  
Y. Kanaoka ◽  
M. Ikebuchi ◽  
...  
Keyword(s):  
Venous Insufficiency ◽  
Varicose Veins ◽  
Venous Pressure ◽  
Calf Muscle ◽  
Venous Disease ◽  
Muscle Pump ◽  
Vein Thrombosis ◽  
Calf Muscle Pump ◽  
Primary Varicose Veins ◽  
Deep Vein

Objective: To evaluate accurately the calf muscle pump in patients with venous insufficiency using foot vein pressure measurements during three different exercises. Design: Prospective study in three groups, comparing patients with venous disease with controls. Setting: Second Department of Surgery, Tottori University Faculty of Medicine. Patients: Twenty normal legs, 29 legs previously affected by deep vein thrombosis and 36 legs with primary varicose veins. Main outcome measures: The foot vein pressure was measured during ankle dorsiflexions, knee-bending and walking on the spot at 40 paces per minute during which minimum ambulatory venous pressure (AVP) and venous refilling time (VRT) were assessed. Results: The three groups differed significantly from each other in AVP and VRT after dorsiflexion and in AVP during walking on the spot, but not after knee-bending. Conclusion: Dorsiflexion is the most useful exercise distinguishing various severities of venous insufficiency, but walking on the spot is more useful for accurately evaluating the calf muscle pump.

Deep Venous Thrombosis: A Prospective 3-Month Follow-up Using Duplex Scanning and Strain-Gauge Plethysmography

1998 ◽  
Vol 94 (6) ◽  
pp. 651-656 ◽  
Author(s):  
M. C. H. Janssen ◽  
H. Wollersheim ◽  
J. H. Haenen ◽  
W. N. J. C. van Asten ◽  
TH. Thien
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Clinical Symptoms ◽  
Calf Muscle ◽  
Duplex Scanning ◽  
Pump Function ◽  
Muscle Pump ◽  
Calf Muscle Pump ◽  
Function Test

1. The purpose of the study was to evaluate the degree of thrombus regression, development of valvular insufficiency, impaired calf muscle pump function and clinical symptoms after a period of acute deep venous thrombosis. 2. Seventy patients with acute deep venous thrombosis, diagnosed by duplex scanning or venography, received treatment with heparin and oral coumarin derivatives according to a standard protocol. All patients wore graduated compression stockings during the whole study period. Duplex scanning was performed at diagnosis and 1 and 3 months later to measure thrombus mass and reflux. The supine venous pump function test was used to assess calf muscle pump function. 3. Three months follow-up was completed in 60 patients. In total 218 (28%) out of 780 vein segments were initially thrombosed and 134 (17%) could not be traced. A statistically significant reduction of thrombus mass was recorded throughout the study period. Total resolution of thrombosis in all vein segments occurred in 25% of the patients within 1 month and in 40% in 3 months. There was no difference in regression between the various proximal vein segments. Distal segments showed more regression than proximal segments. Reflux occurred in 27% of the initially thrombosed veins and in 15% of the patent veins. Patients who showed total resolution after 1 month had a significantly higher calf muscle pump function than patients without total resolution (70%pf vs 61%pf, P < 0.05). Patients with reflux in two or more segments had a significantly lower calf muscle pump function than patients with reflux in less than two segments (58%pf vs 69%pf, P < 0.05). 4. Using duplex scanning and the supine venous pump function test 3 months after an acute deep venous thrombosis, overall haemodynamic abnormalities and local site of valve incompetence could readily be identified. Patients with haemodynamic abnormalities might be at risk to develop the post-thrombotic syndrome. There was no difference in thrombus regression between the various proximal vein segments. Reflux was significantly more often seen in initially thrombosed veins. Thirty-five percent of the patients developed an abnormal calf muscle pump function after 3 months. Patients with early resolution of thrombus had a higher calf muscle pump function after 3 months.

Non-Invasive Measurement of Venous Muscle Pump Function in the Supine Position

1992 ◽  
Vol 7 (4) ◽  
pp. 146-149 ◽  
Author(s):  
H. J. L. van Gerwen ◽  
A. J. M. Brakkee ◽  
J. P. Kuiper
Keyword(s):  
Supine Position ◽  
Strain Gauge ◽  
Venous Pressure ◽  
University Hospital ◽  
Pressure Reduction ◽  
Pump Function ◽  
Muscle Pump ◽  
Non Invasive ◽  
Strain Gauge Plethysmography ◽  
Leg Movements

Objective: A new non-invasive procedure for testing venous muscle pump function in the horizontal position is presented. Design: The test is based on an indirect method we use for measuring ambulatory venous pressure by means of strain-gauge plethysmography. Setting: University Hospital Nijmegen, The Netherlands. Patients: The results of 28 limbs of 20 patients with deep venous insufficiency are compared with 32 limbs of 16 healthy volunteers. Interventions: The same test is performed in all patients and volunteers: in the supine position a raised venous pressure in the limb is induced by venous congestion. The reduction in venous volume after standardized leg movements is measured by strain-gauge plethysmography and, with an additionally obtained pressure-volume relation, this volume reduction is converted into a pressure reduction. Main outcome measure: The reduction by standardized leg movements of an increased venous pressure is a measure for calf muscle pump function. Results: The mean pressure reduction in the patient group was 47% (standard deviation (SD) = 8%), in the healthy group 77% (SD = 6%). Conclusions: The new ‘supine venous pump function test’ is a promising method for measuring the function of the deep veins. Since the whole procedure is performed in the horizontal positon, the method offers several important advantages.

scholarly journals The Influence of Compressive Stockings on the Haemodynamics in the Lower Extremities

1988 ◽  
Vol 3 (3) ◽  
pp. 147-154 ◽  
Author(s):  
A.J.M. Brakkee ◽  
J.P. Kuiper
Keyword(s):  
Healthy Subject ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Venous Pressure ◽  
Lower Extremities ◽  
Limb Volume ◽  
Pump Function ◽  
Muscle Pump ◽  
Elastic Stocking ◽  
Tissue Compression

The influence of an elastic stocking upon the venous muscle pump function in a healthy subject and in a patient with chronic venous insufficiency is discussed. Taking into account the alinear relationship between venous pressure and limb volume the experiences concerning the effects of tissue compression, some of which seem to be contradictory, are clarified.

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