Acute effects of intermittent sequential compression in venous hypertension.
Chronic venous hypertension produces microangiopathy which often progresses to ulceration. It has been recently observed that intermittent sequential compression (ISC) increases the rate of healing of venous ulcers. The aim of this study was to investigate the effect of this form of therapy on the microcirculation in limbs with venous hypertension. Skin blood flow at rest (RF) was measured by laser Doppler flowmetry at the perimalleolar region at rest (horizontal position) and on standing in 34 limbs with chronic venous hypertension (17 with ulcerations) and 20 limbs of healthy volunteers. The venoarteriolar response (VAR = the vasoconstrictory response on standing) was also measured. Also 8 limbs with venous hypertension not treated with ISC were studied to evaluate the effects of supine resting alone on the microcirculation. Two treatment protocols were used. In Study 1 intermittent sequential compression was applied for 30 minutes. Laser-Doppler measurements were performed at time 0 (before intermittent sequential compression) and after 30, 60 and 90 minutes. In Study 2 intermittent sequential compression was applied for 60 minutes and measurements were performed at time 0 and after 60 and 120 and 180 minutes. In patients of Study 1 RF was 1.45 +/- 0.8, significantly higher than in normals (p < 0.05) and the venoarteriolar response only 7%, significantly lower than in normals. At the end of the compression period there was a marked change towards normality as RF decreased (1.1 +/- 0.2) while the change in venoarteriolar response was not significant. At 60 and 90 minutes the changes in RF were still significant (p < 0.05) and the VAR was significantly increased (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Belcaro
G V
GV
Irvine Laboratory, Academic Surgical Unit, St Mary's Hospital Medical School, London, England.
Nicolaides
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AN
D000328:Adult; D001783:Blood Flow Velocity; D002908:Chronic Disease; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D007866:Leg / Q000098:blood supply*; D008297:Male; D008833:Microcirculation; D011187:Posture; D011312:Pressure; D012867:Skin / Q000098:blood supply; D014647:Varicose Ulcer / Q000503:physiopathology / Q000628:therapy; D014661:Vasoconstriction; D014690:Venous Pressure / Q000502:physiology*