scholarly journals The development of postthrombotic syndrome in relationship to venous reflux and calf muscle pump dysfunction at 2 years after the onset of deep venous thrombosis

2002 ◽  
Vol 35 (6) ◽  
pp. 1184-1189 ◽  
Author(s):  
José H. Haenen ◽  
Mirian C.H. Janssen ◽  
Hub Wollersheim ◽  
Martin A. Van't Hof ◽  
M.J.M. de Rooij ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Calf Muscle ◽  
Postthrombotic Syndrome ◽  
Venous Reflux ◽  
Muscle Pump ◽  
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.

The Effect of Elastic Compression on Calf Muscle Pump Function

1990 ◽  
Vol 5 (1) ◽  
pp. 13-19 ◽  
Author(s):  
D. Christopoulos ◽  
A. N. Nicolaides ◽  
G. Belcaro ◽  
P. Duffy
Keyword(s):  
Venous Pressure ◽  
Haemodynamic Effect ◽  
Calf Muscle ◽  
Venous Reflux ◽  
Venous Capacitance ◽  
Elastic Compression ◽  
Muscle Pump ◽  
Calf Muscle Pump ◽  
Elastic Stockings ◽  
Venous Volume

The haemodynamic effect of elastic compression has been evaluated in 23 patients (26 limbs) with superficial venous incompetence. Ambulatory venous pressure (AVP) and pressure recovery time (RT90) were measured with foot vein canulation. Also the functional venous volume (VV) (venous capacitance), venous reflux and the ejecting capacity of the calf muscle pump were measured with air-plethysmography. The above measurements were made with and without a graduated compression elastic stocking. Elastic compression produced a significant reduction in VV ( P < 0.01). Also a significant decrease in venous reflux and increase in the ejecting capacity of the calf muscle pump ( P < 0.01). The above alterations explain the significant reduction in AVP and prolongation of RT90 ( P < 0.01) which was observed as a result of elastic compression. The measurements made in this study demonstrate in an objective and quantitative way the beneficial effect of elastic stockings in patients with superficial venous incompetence and how this effect is achieved.

The Long-Term Effect of Elastic Compression on the Venous Haemodynamics of the Leg

1991 ◽  
Vol 6 (2) ◽  
pp. 85-93 ◽  
Author(s):  
D. Christopoulos ◽  
A. N. Nicolaides ◽  
G. Belcaro
Keyword(s):  
Venous Pressure ◽  
Haemodynamic Effect ◽  
Calf Muscle ◽  
Venous Reflux ◽  
Elastic Compression ◽  
Muscle Pump ◽  
Calf Muscle Pump ◽  
Before And After ◽  
Venous Volume

The long-term haemodynamic effect of elastic compression has been evaluated in 16 patients (20 limbs) with superficial venous incompetence. Ambulatory venous pressure (AVP) and pressure recovery time (RT90) were measured with foot vein canulation. Air-plethysmography was used to measure venous volume, venous reflux and the ejecting capacity of the calf muscle pump, before and after the application of graduated elastic stockings, for 4 weeks. Limbs were tested without the stockings. Elastic compression for 4 weeks produced a significant reduction in the venous volume ( P < 0.01), a significant decrease in venous reflux and an increase in the ejecting capacity of the calf muscle pump ( P < 0.01). The above changes explain the significant reduction in AVP and prolongation of RT90 ( P < 0.01) which was observed. The results indicate that there is a considerable improvement in venous haemodynamics after 4 weeks support with graduated elastic compression.

Venous reflux has a limited effect on calf muscle pump dysfunction in post-thrombotic patients

2000 ◽  
Vol 98 (4) ◽  
pp. 449 ◽  
Author(s):  
José H. HAENEN ◽  
Mirian C.H. JANSSEN ◽  
Alphonsus J.M. BRAKKEE ◽  
Herman VAN LANGEN ◽  
Hub WOLLERSHEIM ◽  
...  
Keyword(s):  
Calf Muscle ◽  
Venous Reflux ◽  
Limited Effect ◽  
Muscle Pump ◽  
Calf Muscle Pump

Venous reflux has a limited effect on calf muscle pump dysfunction in post-thrombotic patients

2000 ◽  
Vol 98 (4) ◽  
pp. 449-454 ◽  
Author(s):  
José H. HAENEN ◽  
Mirian C. H. JANSSEN ◽  
Alphonsus J. M. BRAKKEE ◽  
Herman VAN LANGEN ◽  
Hub WOLLERSHEIM ◽  
...  
Keyword(s):  
Calf Muscle ◽  
Duplex Scanning ◽  
Valsalva Manoeuvre ◽  
Venous Reflux ◽  
Venous Outflow ◽  
Limited Effect ◽  
Reflux Time ◽  
Pump Function ◽  
Muscle Pump ◽  
Calf Muscle Pump

The purpose of the present study was to evaluate the relationship between calf muscle pump dysfunction (CMD) and the presence and location of valvular incompetence. Deep vein obstruction might influence CMD, and so venous outflow resistance (VOR) was measured. VOR and calf muscle pump function were measured in 81 patients, 7–13 years after venographically confirmed lower-extremity deep venous thrombosis. The supine venous pump function test (SVPT) measures CMD, and the VOR measures the presence of venous outflow obstructions, both with the use of strain-gauge plethysmography. Valvular incompetence was measured using duplex scanning in 16 vein segments of one leg. Venous reflux was measured in proximal veins using the Valsalva manoeuvre, and in the distal veins by distal manual compression with sudden release. Abnormal proximal venous reflux was defined as a reflux time of more than 1 s, and abnormal distal venous reflux as a reflux time of more than 0.5 s. No statistically significant relationship was found between the SVPT and either the location or the number of vein segments with reflux. Of the 81 patients, only nine still had an abnormally high VOR, and this VOR showed no relationship with the SVPT. In conclusion, venous reflux has a limited effect on CMD, as measured by the SVPT. The presence of a venous outflow obstruction did not significantly influence the SVPT. Duplex scanning and the SVPT are independent complementary tests for evaluating chronic venous insufficiency.

Calf Muscle Pump Stimulation as a Means to Reduce Symptoms of Fibromyalgia Syndrome

2014 ◽  
Vol 17 (3) ◽  
pp. 334-339 ◽  
Author(s):  
Lynn M. Baniak ◽  
Carolyn S. Pierce ◽  
Erik Hiester ◽  
Kenneth J. McLeod
Keyword(s):  
Fibromyalgia Impact Questionnaire ◽  
Additional Treatment ◽  
Calf Muscle ◽  
Attrition Rate ◽  
Widespread Pain ◽  
Muscle Pump ◽  
Calf Muscle Pump ◽  
Revised Fibromyalgia Impact Questionnaire ◽  
Change In Mean ◽  
Quiet Sitting

Fibromyalgia (FM) is a debilitating chronic condition that often affects women in midlife with widespread pain that interrupts attempts to exercise. The purpose of this pilot study was to test the efficacy of calf muscle pump (CMP) stimulation as an adjuvant therapy for FM by (1) assessing the correlation of the level of symptoms, as measured by the revised Fibromyalgia Impact Questionnaire (FIQR), and blood pressure (BP), (2) measuring change in mean FIQR scores for subjects who use a CMP-stimulation device for 12 weeks, and (3) measuring the correlation of total device usage and the level of symptoms as measured by the FIQR. The 29 male and female participants (mean age = 47.3 years) were screened using the Widespread Pain Index (WPI), Symptom Severity (SS) score, and the FIQR. Participants were contacted weekly, and progress was assessed using the WPI, SS score, and the FIQR as well as general questions regarding responses to CMP stimulation. The attrition rate was high, which is not uncommon in studies of patients with FM. We found that diastolic BP was significantly inversely correlated with baseline FIQR scores during quiet sitting. Further, 12 weeks of CMP stimulation was associated with significant improvement in average FIQR scores at a rate of approximately −1.5 points per week ( R2 = .9; p ≤ .0001). Total device usage was strongly and inversely correlated with baseline FIQR scores ( R2 = .43; p = .02). These findings suggest that CMP stimulation may provide an additional treatment option for individuals with FM who are challenged to perform traditional forms of exercise.

Risk factors of postthrombotic syndrome before and after deep venous thrombosis treatment

2016 ◽  
Vol 32 (6) ◽  
pp. 384-389 ◽  
Author(s):  
Rob HW Strijkers ◽  
Mark AF de Wolf ◽  
Cees HA Wittens
Keyword(s):  
Risk Factors ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Treatment Options ◽  
Postthrombotic Syndrome ◽  
Factor X ◽  
Catheter Directed Thrombolysis ◽  
Before And After ◽  
Patient Selection Criteria ◽  
The Moment

Postthrombotic syndrome is the most common complication after deep venous thrombosis. Postthrombotic syndrome is a debilitating disease and associated with decreased quality of life and high healthcare costs. Postthrombotic syndrome is a chronic disease, and causative treatment options are limited. Prevention of postthrombotic syndrome is therefore very important. Not all patients develop postthrombotic syndrome. Risk factors have been identified to try to predict the risk of developing postthrombotic syndrome. Age, gender, and recurrent deep venous thrombosis are factors that cannot be changed. Deep venous thrombosis location and extent seem to predict severity of postthrombotic syndrome and are potentially suitable as patient selection criteria. Residual thrombosis and reflux are known to increase the incidence of postthrombotic syndrome, but are of limited use. More recently developed treatment options for deep venous thrombosis, such as new oral factor X inhibitors and catheter-directed thrombolysis, are available at the moment. Catheter-directed thrombolysis shows promising results in reducing the incidence of postthrombotic syndrome after deep venous thrombosis. The role of new oral factor X inhibitors in preventing postthrombotic syndrome is still to be determined.

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