Hemodynamic Evaluation of Venous Function After Surgical Treatment of Varicose Veins

Abstract

In the present study, venous function was evaluated by simultaneous strain gauge plethysmographic (SGP) and photoplethysmographic (PPG) techniques before and after varicose vein surgery. In plethysmography, expelled volume dur ing five active dorsiflexions of the feet and venous recovery time were calcu lated to evaluate muscle efficiency and valvular competence. This technique was applied in 46 limbs of 31 patients with varicose veins and 40 limbs of 20 normal subjects. Postoperative tests showed an improvement in venous function. In the early stage after operation, however, all parameters were still lower than those in the normal group. This early postoperative venous dysfunction may be due to residual incompetence of the small veins and reduction of the communica tions between the superficial veins or the superficial and deep veins. The parameters improved three and six months after surgery, suggesting a recovery of the tone of the small veins and the development of collaterals. One year postoperatively, however, the venous function worsened again. After applica tion of a tourniquet below the knee, the half-refilling time was prolonged sig nificantly in both the SGP and PPG tracings, indicating that abnormal reflux of the superficial veins had worsened one year after surgery.