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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.
Background:
To study the evacuation function of calf muscle-venous pump (CMP) in patients with pelvic venous disorder (PeVD).
Methods:
This single-center cross-sectional study included 170 female patients (120 with PeVD ± chronic venous disease (CVD) and 50 with CVD without PeVD) and 20 healthy volunteers. All subjects underwent duplex ultrasound (DUS) of the pelvic and lower extremity veins, radionuclide venography (RV) of the lower extremities, and single-photon emission computed tomography (SPECT) of the pelvic veins (PVs) with in vivo labeled red blood cells (RBCs). The pelvic venous congestion (PVC) signs were deposition of labeled RBCs in the PVs and the PVC coefficient (CPVC) > 0.5. The CMP evacuation dysfunction was identified during RV as an increase in the average isotope transit time (Tave) in the tendon (Tt) and muscle (Tm) parts of CMP and in the popliteal vein (Tpv).
Results:
The CMP dysfunction was detected in 81.6% and 78.3% of patients with symptomatic and asymptomatic PeVD, accordingly, and in 92% of patients with CVD. This condition was characterized by a significant increase in the isotope transit time (Tt 18-30 s, Tm 27-45 s, and Tpv 20-40 s).
Conclusion:
The CMP dysfunction is present in about 80% of patients with PeVD, regardless of the clinical course of PeVD and the presence of CVD of the lower extremities.
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