Venous Pressure Gradients in Patients with Chronic Venous Disease

Abstract

Venous pressure was measured simultaneously in a vein of the calf and the foot in five healthy controls and 10 patients with superficial chronic venous insufficiency (CVI). In both groups ambulatory venous pressure decreased more in the foot veins than in the calf veins. In patients with CVI the mean difference in foot and calf ambulatory venous pressure reduction (AVPR) was 25.5 mmHg, as was found in the controls (24.6 mmHg). During compression of superficial veins the difference in AVPR was reduced in patients but not in controls (11.6 vs 27.0 mmHg, respectively). About 50% of this difference in AVPR could be ascribed to the difference in cannulation height (except for the meaurement with superficial compression in patients where the whole difference in AVPR could be ascribed to the difference in cannulation height). Pressure changes during ambulation in the dorsal foot vein and calf veins may differ considerably, dependent on the existance of a specific foot vein pump and sufficiency of venous valves at the level of the ankle. Therefore, veins proximal to the ankle should be used for pressure recordings in the evaluation of chronic venous insufficiency in the calf.