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Calf Muscle-Venous Pump Dysfunction in Patients with Pelvic Venous Disorder
Sergey G Gavrilov1, Anatoly V Karalkin1, Ekaterina P Moskalenko1
1Savelyev University Surgical Clinic, Pirogov Russian National Research Medical University, Moscow, Russia.
Annals of Vascular Surgery
|March 26, 2025
Summary
Calf muscle-venous pump (CMP) dysfunction is common in pelvic venous disorder (PeVD), affecting around 80% of patients. This dysfunction impacts venous return regardless of PeVD symptoms or co-existing chronic venous disease (CVD).
Area of Science:
- Vascular Medicine
- Medical Imaging
- Physiology
Background:
- Pelvic venous disorder (PeVD) is a condition affecting venous return from the pelvis.
- The calf muscle-venous pump (CMP) plays a crucial role in lower limb venous return.
- Understanding CMP function in PeVD is essential for diagnosis and management.
Purpose of the Study:
- To investigate the evacuation function of the calf muscle-venous pump (CMP) in patients diagnosed with pelvic venous disorder (PeVD).
- To assess the prevalence and characteristics of CMP dysfunction in individuals with PeVD, with or without chronic venous disease (CVD).
Main Methods:
- A cross-sectional study involving 170 female patients with PeVD and/or CVD, and 20 healthy volunteers.
- Utilized duplex ultrasound (DUS), radionuclide venography (RV), and single-photon emission computed tomography (SPECT) with labeled red blood cells (RBCs).
- Identified CMP dysfunction by increased isotope transit time (Tave) in CMP and popliteal veins during RV.
Main Results:
- CMP dysfunction was observed in 81.6% of symptomatic and 78.3% of asymptomatic PeVD patients.
- A high prevalence of CMP dysfunction (92%) was also noted in patients with CVD.
- This dysfunction was characterized by significantly prolonged isotope transit times in the tendon (Tt), muscle (Tm), and popliteal veins (Tpv).
Conclusions:
- Calf muscle-venous pump (CMP) dysfunction is a prevalent finding in approximately 80% of patients with pelvic venous disorder (PeVD).
- The presence of CMP dysfunction in PeVD patients is largely independent of the clinical presentation of PeVD or the co-existence of lower extremity chronic venous disease (CVD).
- These findings highlight the significant impact of pelvic venous issues on lower limb venous hemodynamics via the CMP.
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