Abstract
Objective: To investigate the acute effects of sequential compression on the microcirculation in limbs with chronic venous hypertension causing venous microangiopathy. Design: One group of patients with venous hypertension and a group of normal, comparable subjects were treated with intermittent sequential pneumatic compression applied for 30 min. Skin blood flow was measured by laser Doppler flowmetry at the perimalleolar region at rest (horizontal position) and on standing. The measurements were repeated at 0, 30 and 60 min after cessation of the compression. As criteria of inclusion, only limbs with high perimalleolar skin flux and decreased venoarteriolar response were included. Setting: St Mary's Hospital, London (teaching hospital). Patients, participants: Sixteen limbs in 16 patients with chronic venous hypertension and 12 limbs of comparable healthy volunteers were studied. Results: At rest, in the normal controls, the mean (SD) flux was 0.56 (0.3) units; it decreased on average by 35% on standing (venoarteriolar response). There was normal vasomotor activity. In patients, the mean flux was 1.45 (0.8) ( p < 0.025) and the median venoarticular response only 7%. There was very limited vasomotor activity. Vasomotor activity started 10 min after the commencement of compression. At the end of the compression period there was a marked change towards normality. Resting flux was 0.90 (0.5) (significantly decreased) and the venoarteriolar response had increased to 23% ( p < 0.025) with an improvement in vasomotor activity. These changes persisted at 30 and 60 min. Conclusions: The findings offer an explanation of the effect of sequential compression on the healing of leg ulcers in chronic venous insufficiency.
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