title: Lower limbs venous kinetics and consequent impact on drainage direction.
abstract: Background Literature concerning the lower limbs physiological venous haemodynamics is still lacking of reference velocity values and consequent impact on drainage direction. Aim of the present study is to assess the flow velocities in the different venous compartments, evaluating the possible Venturi effect role, thus finding clues for the identification of the physical model governing the flow direction. Methods Thirty-six lower limbs underwent a velocity and diameters echo-color-Doppler assessment in several anatomical point of analysis along both the deep and superficial venous systems. The investigation protocol included and compared two different manoeuvres to elicit the flow: manual calf compression/relaxation (CR) and active foot dorsiflexion (AFD). Both peak systolic (PSV) and time average velocities (TAV) were measured. Results The different venous segments demonstrated an overlap among the velocity values and the anatomical subdivision of the deep and superficial compartments. At the CR, TAV was 34 ± 12 cm/s in the deep venous system (N1), 15 ± 7 cm/s in the saphenous system (N2), 5 ± 2 cm/s in the saphenous tributaries (N3); PSV was 89 ± 35 cm/s in N1, 34 ± 16 cm/s in N2, 11 ± 4 cm/s in N3, p < 0.05. At the AFD, TAV was 33 ± 13 cm/s in N1, 15 ± 7 in N2, 9 ± 5 in N3; PSV was 83 ± 35 in N1, 32 ± 17 in N2, 15 ± 4 in N3, p < 0.05. A diameter decrease was reported from N1 to N3 ( p < 0.05). Conclusion This investigation provides evidences of the velocity decrease from the deepest to the most superficial compartments. These data introduce the Venturi effect as potential factor in the flow aspiration from the tributary to the deeper veins. The reported data represent a first step towards an objective evaluation of the physic laws governing the drainage. These values can constitute the basis for further investigations in pathological and post-procedural scenarios.
authors.affiliation: 1 Vascular Disease Center, Unit of Translational Surgery, University of Ferrara, Ferrara, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Gianesini
authors.affiliation: 2 Department of Physics and Earth Sciences, University of Ferrara, Ferrara, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Sisini
authors.affiliation: 2 Department of Physics and Earth Sciences, University of Ferrara, Ferrara, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Domenico
authors.affiliation: 2 Department of Physics and Earth Sciences, University of Ferrara, Ferrara, Italy.
authors.forename: Joel
authors.initials: J
authors.lastname: Secchiero
authors.affiliation: 1 Vascular Disease Center, Unit of Translational Surgery, University of Ferrara, Ferrara, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Malagoni
authors.affiliation: 1 Vascular Disease Center, Unit of Translational Surgery, University of Ferrara, Ferrara, Italy.
authors.forename: Erica
authors.initials: E
authors.lastname: Menegatti
authors.affiliation: 2 Department of Physics and Earth Sciences, University of Ferrara, Ferrara, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Gambaccini
authors.affiliation: 1 Vascular Disease Center, Unit of Translational Surgery, University of Ferrara, Ferrara, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Zamboni
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007700:Kinetics; D035002:Lower Extremity / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008955:Models, Cardiovascular; D011152:Popliteal Vein / Q000503:physiopathology*; D011446:Prospective Studies; D012039:Regional Blood Flow; D013599:Systole; D018616:Ultrasonography, Doppler, Duplex; D014680:Veins / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014689:Venous Insufficiency / Q000000981:diagnostic imaging* / Q000503:physiopathology; D055815:Young Adult
keywords: Active foot dorsiflexion; Duplex ultrasound; Physics; Physiology; Venous flow