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Peripheral nerve function in chronic venous insufficiency

S K Shami1, D A Shields, J Farrah

  • 1University College and Middlesex School of Medicine, London, U.K.

European Journal of Vascular Surgery
|March 1, 1993
PubMed
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Patients with chronic venous insufficiency (CVI) and lipodermatosclerosis exhibit peripheral neuropathy. This nerve damage, affecting warming and vibration sensation, may contribute to the development of venous ulcers.

Area of Science:

  • Vascular Medicine
  • Neurology
  • Dermatology

Background:

  • Chronic venous insufficiency (CVI) is linked to altered skin microcirculation, including vasomotion abnormalities and impaired venoarteriolar reflex.
  • Liposclerotic skin in CVI patients suggests potential nervous system involvement in the condition's pathophysiology.

Purpose of the Study:

  • To investigate the presence of peripheral neuropathy in patients diagnosed with chronic venous insufficiency (CVI) and lipodermatosclerosis.
  • To assess nerve fiber function in CVI patients compared to healthy controls.

Main Methods:

  • Evaluated 40 CVI patients with lipodermatosclerosis and 35 controls for neuropathy using sensory testing.
  • Assessed unmyelinated nerve fibers via threshold to warming and myelinated fibers via thresholds to cooling and vibration.

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  • Utilized a computer-controlled instrument for thermal thresholds and a Bio-thesiometer for vibration thresholds on the foot and toe.

    • Main Results:

    • CVI patients demonstrated significantly higher thresholds for warming and vibration compared to controls (p=0.005 and p=0.024, respectively).
    • No significant difference was observed in the threshold to cooling between the CVI group and the control group.
    • These findings indicate sensory nerve dysfunction in individuals with CVI and lipodermatosclerosis.

    Conclusions:

    • This study provides evidence for peripheral neuropathy in patients suffering from chronic venous insufficiency.
    • The identified neuropathy may play a crucial role in the pathogenesis of chronic venous ulceration.