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Muscle changes in venous insufficiency.

S A Taheri, R Heffner, J Williams

    Archives of Surgery (Chicago, Ill. : 1960)
    |August 1, 1984
    PubMed
    Summary
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    Venous insufficiency and hypertension cause skeletal muscle injury, potentially due to disuse, denervation, or ischemia. This muscle damage may explain elevated creatine kinase and failed surgical outcomes in patients.

    Area of Science:

    • Vascular Surgery
    • Orthopedic Surgery
    • Muscle Pathophysiology

    Background:

    • Venous insufficiency and hypertension are common conditions affecting lower limbs.
    • Skeletal muscle damage is a known complication of chronic venous disease.
    • Autogenous vein valve transplant is a surgical option for venous valvular insufficiency.

    Purpose of the Study:

    • To investigate the pathological changes in skeletal muscle of patients with venous insufficiency and hypertension.
    • To determine the potential causes of skeletal muscle injury in this patient population.
    • To correlate skeletal muscle injury with preoperative serum creatine kinase levels and postoperative surgical outcomes.

    Main Methods:

    • Diagnosis of venous insufficiency and hypertension using venography, venous pressure measurements, and photoplethysmography in 53 patients.

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  • Pathological examination of gastrocnemius muscle biopsy specimens obtained preoperatively.
  • Measurement of serum creatine kinase levels preoperatively.

    • Main Results:

    • Three types of morphologic injury were identified in skeletal muscle biopsies.
    • Disuse, denervation, and ischemia were suggested as contributing factors to muscle damage.
    • Preoperative elevations in serum creatine kinase levels were observed in many patients.

    Conclusions:

    • Skeletal muscle injury is a significant finding in patients with venous insufficiency and hypertension.
    • The identified muscle injuries may be multifactorial, involving disuse, denervation, and ischemia.
    • Skeletal muscle damage likely contributes to elevated serum creatine kinase and may impact the success of venous reconstructive surgery.