Noninvasive diagnosis of the main forms of venous hypertension in patients with varicosity
Sukovatykh, B.S.; Belikov, L.N.; Rodionov, O.N.; Sukovatykh, M.B.
Angiologiia i Sosudistaia Khirurgiia 9(1): 46-51
2003
ISSN/ISBN: 1027-6661 PMID: 12811392 Document Number: 562554
The mechanisms of the development of venous hypertension were studied in 212 patients with varicosity. The clinical and instrumental research methods (rheovasography, photoplethysmography, duplex scanning) were employed. Two groups of patients suffering from superficial (simple) and deep (complicated) forms of venous hypertension were distinguished. The superficial form (85.3%) largely occurs under the action of the hydrostatic force of gravitation nature. The axial reflux via the sapheno-femoral and sapheno-popliteal anastomoses, which occurs when the patient is in the vertical position produces insufficiency of the superficial venous valves. The musculovenous pump maintains its function. That is why the hydrody-namic effects via the insufficient perforating veins play a less important part in the development of venous stasis. Trophic disorders emerge 20-30 years after the disease onset and are associated with the development of fairly intensive blood refluxes in the superficial and perforating veins. Dysfunction of the musculovenous pump of the lower extremities underlies the formation of deep hypertension (14.7%). Primary valvular insufficiency of the deep veins induces the formation of hemo-dynamically significant refluxes in the deep, superficial and perforating veins. The work of the musculovenous pump is far from promoting venous return. On the contrary, the movement is associated with an increase in blood volume in all elements of the pump. At first this leads to phlebostasis and then to capillary stasis, provoking the development of trophic disorders at the early stages of disease.