In situ hemodynamics of perforating veins in Chronic Venous Disease (CVD)

The prevalence of incompetent perforating veins increases linearly with the clinical severity of Chronic Venous Disease (CVD) and the presence of deep vein incompetence. Putative transmission of deep vein pressure to skin may cause dermal hypoxia and ulcers.

Despite extensive prospective interest in the contribution of perforators toward Chronic Venous Disease (CVD), their hemodynamic role remains controversial. The aim of this prospective study was to determine the in situ hemodynamic performance of incompetent perforating veins across the clinical spectrum of Chronic Venous Disease (CVD), by means of duplex ultrasonography.

A total of 265 perforating veins that had clinical signs and symptoms consistent with Chronic Venous Insufficiency (CVI). In addition to an increase in diameter, perforator incompetence is characterized by significantly higher mean and peak flow velocities, volume flow, and venous volume displaced outward, and a lower flow pulsatility. Differences in early reflux enable a better hemodynamic stratification of incompetent perforating veins in Chronic Venous Disease (CVD) classes.

Source: K T Delis, J Vasc Surg, 2001 Apr;33⁴:773-82. doi: 10.1067/mva.2001.112707.

K T Delis, J Vasc Surg, 2001 Apr;33⁴:773-82. doi: 10.1067/mva.2001.112707.

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