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Kenneth C. Shull, MD; Andrew N. Nicolaides, MS, FRCS, FRCSE; J. Fernandes é Fernandes, MD; Campbell Miles, FRACS; Joe Homer, FRCS; Terry Needham; Ernest D. Cooke, MD; Felix H. G. Eastcott, MS, FRCS

Arch Surg. 1979;114(11):1304-1306.

Abstract
• Fifty-one patients (55 limbs) who had had deep venous thrombosis (DVT) extending into the femoral or iliofemoral segment three to five years earlier and ten limbs of ten healthy volunteers were studied. The ambulatory venous pressure (AVP) was measured by inserting a needle in a vein on the foot; the presence of reflux in the popliteal vein was determined by a directional Doppler ultrasonic blood velocity detector. All patients had ascending venography. The results suggest that the most important factor in determining the AVP and ulceration in postthrombotic limbs is the condition of the popliteal valves. Ulceration does not occur even in the presence of occlusion if the popliteal valves are competent. The extent of DVT and recanalization or the failure of recanalization is of secondary importance.

(Arch Surg 114:1304-1306, 1979)

Author Affiliations
From the Academic Surgical Unit and Cardiovascular Unit, Clinical Vascular Laboratory, St Mary's Medical School (Drs Shull, Nicolaides, Fernandes, Miles, Horner, and Eastcott and Mr Needham), and the Department of Medical Electronics, St Bartholemeus Hospital Medical School (Dr Cooke), London. Dr Shull is now at High Point Memorial Hospital, High Point, NC.

Footnotes
Accepted for publication July 23, 1979.

Read before the 27th scientific meeting of the International Cardiovascular Society, June 28, 1979, Nashville, Tenn.

Reprint requests to Clinical Vascular Laboratory, St Mary's Hospital, Praed St, London W2, England (Dr Nicolaides).

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