Leg Ulcer Patients: No Decreased Fibrinolytic Response but White Cell Trapping after Venous Occlusion of the Upper Limb

Abstract

Objective:

To study changes in indicators of fibrinolytic activity and white cell trapping in response to raised venous pressure in the upper limbs of patients with chronic venous insufficiency.

Design:

Comparison of disease group versus control group study.

Setting:

Departments of Dermatology and Medicine, University of Freiburg.

Patient:

Thirty patients with chronic venous insufficiency and thirty control subjects of similar age with unrelated conditions.

Interventions:

The venous pressure was raised in one upper limb by application of a sphygmomanometer cuff around the upper arm for a period of 10 minutes.

Main outcome measures:

Red cell count, white cell count, plasminogen activator inhibitor, tissue plasminogen activator were measured in blood drawn from the arm subjected to raised venous pressure.

Results:

No significant changes were observed in the parameters of fibrinolytic activity. After 10 minutes of venous hypertension the white cell trapping in the disease group was 17.7% (interquartile range, 10.7–22), compared with 12.8% (interquartile range 4.9–16.1%) in the control group.

Conclusion:

The differences in white cell trapping parameters between healthy control subjects and patients with chronic venous insufficiency is probably attributable to systemic activation of white cells associated with their venous disease.