Muscle changes in venous insufficiency
S. A. Taheri, R. Heffner, J. Williams, L. Lazar and S. Elias
The diagnosis of venous insufficiency and hypertension was established in
53 patients using standard diagnostic methods including ascending and
descending venography, venous pressure measurements, and
photoplethysmography. Autogenous vein valve transplant, which is gaining
acceptance as a treatment for this condition, was employed in this group of
patients to relieve venous valvular insufficiency. Biopsy specimens of the
gastrocnemius muscle were obtained before surgery in all 53 patients and
studied pathologically. Three types of morphologic injury were encountered,
suggesting that disuse, denervation, and ischemia may each be partially
responsible for damage in skeletal muscle subjected to venous insufficiency
and hypertension. Skeletal muscle injury probably explains the preoperative
elevations of serum creatine kinase levels in many of our patients and may
account for the failure of venous pressures to return to normal levels
following surgery.
