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Reflux volume is determined by ejected blood volume from the calf venous reservoir

Roman A Tauraginskii1, Fedor Lurie2, Konstantin Zhdanov3

  • 1International Institution of Health Care and Additional Education Research Institute of Clinical Medicine, Irkutsk, Russia; Phlebology Department, LLC Vein Center "Antireflux," Surgut, Russia.

Journal of Vascular Surgery. Venous and Lymphatic Disorders
|March 18, 2020
PubMed

Insights

Ejection volume (EV) from the calf reservoir significantly influences reflux volume (RV) in patients with incompetent great saphenous veins. Higher reflux index (IR) and RV correlate with more severe chronic venous disease.

Area of Science:

  • Vascular Medicine
  • Phlebology
  • Diagnostic Ultrasound

Background:

  • Chronic venous disease (CVD) affects millions globally, often involving the great saphenous vein.
  • Assessing venous reflux is crucial for diagnosing and managing CVD.
  • Current methods for reflux assessment may benefit from refined quantitative analysis.

Purpose of the Study:

  • To investigate the relationship between ejected blood volume (EV) and reflux volume (RV) during a standardized cuff inflation-deflation maneuver.
  • To determine if cuff pressure influences the reflux index (IR) in patients with great saphenous vein incompetence.
  • To correlate reflux parameters with the severity of chronic venous disease.

Main Methods:

  • 48 patients with chronic venous disease underwent a non-cycling distal cuff inflation-deflation maneuver.
  • Duplex ultrasound assessed common femoral and great saphenous vein parameters.
  • Reflux volume (RV), ejection volume (EV), and reflux index (IR = RV/EV) were calculated at 60, 90, and 120 mm Hg cuff pressures.

Main Results:

  • RV showed significant correlations with EV (r² = 0.366) and reflux flow rate (Qreflux) (r² = 0.647).
  • RV and EV varied significantly across different cuff pressures (P < .0001).
  • The reflux index (IR) remained consistent across all tested cuff pressures (approx. 0.42-0.43).

Conclusions:

  • Ejection volume (EV) is the primary determinant of reflux volume (RV) during distal cuff compression-decompression.
  • Both RV and the reflux index (IR) are associated with the severity of chronic venous disease.
  • The reflux index provides a stable measure of venous reflux, independent of cuff pressure.
Abstract

Keywords:
Calf muscle pumpDuplex ultrasoundEjection volumeReflux volumeVaricose veinsVenous reflux

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