Non-invasive assessment of human large vein diameter, capacity, distensibility and ellipticity in situ: dependence on anatomical location, age, body position and pressure

Abstract

The objective was to compare in-situ diameter, capacity and distensibility changes as well as ellipticity of large human veins of different locations, reveal alterations with age, body position and increased intraluminal pressure. Ultrasonographic assessment of mediolateral and anteroposterior diameters was performed of femoral, axillary and inner jugular veins, in erect and reclined positions as well as before and during controlled Valsalva test. Groups of young (24.0+/-0.4 years, n=11) and elderly (72.6+/-1.5 years, n=11) subjects were studied. Capacity of the femoral vein (reclined patients) gradually increased when a graded Valsalva test was applied. Its in situ distensibility was found to be 0.048+/-0.011 mm Hg(-1) between 0-15 mm Hg (1 mm Hg=0.133 kPa) pressure loads in reclined young subjects, which decreased to 0.009+/-0.005 mm Hg(-1) at 45-60 mm Hg. The femoral vein was considerably more rigid in the erect than in the reclined body position while an opposite correlation was found for the inner jugular vein. Axillary vein distensibility was very low and independent of body position. Ellipticity of femoral and axillary veins was minimal (the ratio of the two perpendicular diameters <1.25). Inner jugular veins were more elliptic in the erect position and without Valsalva (2.94+/-0.99 in young patients). Old femoral veins had higher capacity in the reclined position without Valsalva, while distensibility at low pressures was much more prominent in young vessels. The in situ femoral vein is more distensible in supine than in erect position, opposite to the inner jugular vein. The axillary vein is rather rigid in both positions. Only the inner jugular vein shows significant elipticity in situ. Aging decreases the distensibility of the femoral vein in reclined position.