Intramuscular pressure, venous function and muscle blood flow in patients with lymphedema of the leg

Intramuscular pressure, muscle blood flow and venous emptying was studied in seven patients with unilateral lymphedema of the leg. Intramuscular pressure was measured with the wick technique. Muscle blood flow was assessed by means of the 133Xenon clearance technique. Venous emptying was studied with strain gauge technique. Intramuscular pressure in the anterior tibial compartment of the edematous leg was 30 +/- 14 mmHg at rest, rising to 49 +/- 16 mmHg during exercise (p less than 0.05). In the healthy leg the pressure rose from 16 +/- 8 mmHg at rest to 28 +/- 6 mmHg during exercise (p less than 0.05). In the deep posterior compartment similar pressure values were obtained. Muscle blood flow during exercise was significantly higher (p less than 0.05) in the healthy leg, 32.4 +/- 6.8 ml X min-1 X (100 g)-1 than in the edematous leg, 29.9 +/- 4.8 ml X min-1 X (100 g)-1. Venous emptying was significantly lower (p less than 0.05) in the diseased leg, 44.7 +/- 18.7 ml X min-1 X (100 g)-1 than in the healthy leg, 61.4 +/- 18,9 ml X min-1 X (100 g)-1. Thus, lymphatic obstruction of the leg causes edema which leads to an increased intramuscular pressure and a decreased muscle blood flow and venous emptying.