Venous haemodynamics--a consideration of macro- and microvascular effects

In health, valves in the deep veins function unidirectionally permitting blood flow towards the heart. This function is often degraded following deep vein thrombosis leading to venous hypertension and disturbed haemodynamics in the legs of the patient. Hypertension, in turn, promotes venous ulceration through a series of degenerative pathological steps. Traditional methods of treatment include leg elevation and compression using elasticated garments or bandaging. These techniques manage the problem with varying success but do not cure it. Recent advances in surgical research suggest that novel techniques are being developed for treating valve incompetence. In these circumstances, vascular scientists should be examining methods of addressing both the macro- and the microcirculation so that changes in these consequent to venous hypertension may be measured. This review examines existing methods of measuring the macrocirculation as well as the potential techniques to study effects of venous haemodynamics in the microcirculation.