Noninvasive evaluation of chronic venous insufficiency. Use of foot mercury strain-gauge plethysmography
H. Schanzer, L. Lande, G. Premus and E. C. Peirce 2nd
Twenty-seven patients (40 extremities) with chronic venous insufficiency
and 30 controls (60 extremities) were studied using noninvasive
measurements of foot volume (foot mercury strain-gauge plethysmography
[FMSGP]). Tests were performed with exercise (sitting) and with elevation
(Trendelenburg), with and without tourniquets, to evaluate muscle pump
efficiency and valvular competence. Empiric venous sufficiency indexes were
calculated for exercise and for Trendelenburg's test. Test results were
compared with invasive ambulatory venous pressure (AVP) data (13) and with
ascending and retrograde venography (25). Distinctive plethysmographic
patterns revealed the insufficiency was saphenous (four), calf perforators
(14), saphenous plus perforators (seven), and deep venous (15), including
occlusion (four). Correlation with AVP and venography was good but FMSGP
was more discriminating, providing precise anatomical information, better
reproducibility, and distinguishing poor muscle pump function from
regurgitation. Patients accept FMSGP well. Repeated postoperative data are
readily obtained for evaluation of surgical procedures.
