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Hemodynamic assessment of venous problems.

W H Pearce, J B Ricco, L A Queral

    Surgery
    |May 1, 1983
    PubMed
    Summary

    Photoplethysmography (PPG) measures venous refilling time to assess venous function. Shortened refilling times indicate postphlebitic syndrome and correlate with incompetent perforating veins, aiding in diagnosis and treatment assessment.

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    Area of Science:

    • Vascular Medicine
    • Diagnostic Imaging
    • Hemodynamics

    Background:

    • Postphlebitic syndrome and varicose veins significantly impact venous function.
    • Accurate assessment of venous hemodynamics is crucial for effective patient management.
    • Photoplethysmography (PPG) offers a non-invasive method for evaluating venous return.

    Purpose of the Study:

    • To objectively assess venous function using venous refilling time (VRT) measured by PPG.
    • To correlate VRT with clinical conditions like postphlebitic syndrome, varicose veins, and deep vein thrombosis (DVT).
    • To evaluate the hemodynamic significance of venous valve incompetence and the efficacy of vein stripping.

    Main Methods:

    • Recruited 89 patients with postphlebitic syndrome, varicose veins, or history of DVT.
    • Measured VRT using PPG, comparing results with venographic findings.
    • Utilized tourniquets to assess saphenous vein contribution and evaluated VRT changes post-vein stripping.
    • Conducted serial PPG tests for patients with acute DVT during follow-up.

    Main Results:

    • Symptomatic postphlebitic limbs showed shortened VRT (15.6 ± 11s).
    • Femoral valve incompetence was common (81%) in postphlebitic syndrome, but VRT did not correlate with reflux degree.
    • Shorter VRT was observed with incompetent perforating veins (14 ± 4s) versus limbs without (27 ± 11.9s).
    • Vein stripping for long saphenous vein varicosities normalized VRT (14.43 ± 4.34s to 30.64 ± 11.9s).
    • Persistent abnormal PPG readings in DVT patients predicted postphlebitic changes.

    Conclusions:

    • VRT measured by PPG is a valuable tool for assessing venous hemodynamics.
    • PPG can determine the functional significance of venous valve incompetence and perforating vein dysfunction.
    • VRT effectively evaluates the outcomes of interventions like vein stripping.
    • Serial PPG monitoring in DVT patients can identify those at risk for developing postphlebitic syndrome.

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