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The significance of calf muscle pump function in venous ulceration.
J Vasc Surg. 1994 Dec; 20(6):872-7; discussion 878-9.JV

Abstract

PURPOSE

Patients with clinically evident chronic venous insufficiency were evaluated to relate the degree of insufficiency and calf muscle pump dysfunction to venous ulceration.

METHODS

Sixty-nine limbs in 55 patients with chronic venous insufficiency by Society for Vascular Surgery/International Society for Cardiovascular Surgery Classification were compared in three groups: classes 1 and 2 with no history of ulceration (19 limbs); class 3 with healed ulceration (20 limbs); and class 3 with active ulcers (30 limbs). Air plethysmography measurements of outflow fraction, venous volume, venous filling time, venous filling index, ejection fraction, ejection volume, residual volume fraction, and residual volume were made. In 62 of the 69 limbs, color-flow duplex ultrasonography was used to determine the pattern of reflux.

RESULTS

The outflow fraction was normal in 84%, 75%, and 77% of nonulcerated, healed, and ulcerated limbs. The venous filling index was abnormal in most limbs (nonulcerated 95%, healed 90%, ulcerated 98%) but not significantly different among groups. Differences in calf muscle pump function were significant. Ulcerated limbs had significantly poorer ejection fractions (p = 0.0002) and greater residual volume fractions (p = 0.0006) than nonulcerated or healed limbs. By ultrasonography, deep and superficial vein incompetence was present in most limbs and was not statistically different among groups. Although venous insufficiency was not measurably different among groups, limbs with active venous ulcers had significantly poorer calf muscle pump function than those with healed ulcers or with no history of ulceration.

CONCLUSION

Venous insufficiency is necessary but not sufficient to cause ulceration, and a deficiency of the calf muscle pump is significant to the severity of venous ulceration.

Authors+Show Affiliations

Department of Surgery, University of Medicine and Dentistry of New Jersey, Newark, 07103.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

7990181

Citation

Araki, C T., et al. "The Significance of Calf Muscle Pump Function in Venous Ulceration." Journal of Vascular Surgery, vol. 20, no. 6, 1994, pp. 872-7; discussion 878-9.
Araki CT, Back TL, Padberg FT, et al. The significance of calf muscle pump function in venous ulceration. J Vasc Surg. 1994;20(6):872-7; discussion 878-9.
Araki, C. T., Back, T. L., Padberg, F. T., Thompson, P. N., Jamil, Z., Lee, B. C., Duran, W. N., & Hobson, R. W. (1994). The significance of calf muscle pump function in venous ulceration. Journal of Vascular Surgery, 20(6), 872-7; discussion 878-9.
Araki CT, et al. The Significance of Calf Muscle Pump Function in Venous Ulceration. J Vasc Surg. 1994;20(6):872-7; discussion 878-9. PubMed PMID: 7990181.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The significance of calf muscle pump function in venous ulceration. AU - Araki,C T, AU - Back,T L, AU - Padberg,F T, AU - Thompson,P N, AU - Jamil,Z, AU - Lee,B C, AU - Duran,W N, AU - Hobson,R W,2nd PY - 1994/12/1/pubmed PY - 2001/3/28/medline PY - 1994/12/1/entrez SP - 872-7; discussion 878-9 JF - Journal of vascular surgery JO - J Vasc Surg VL - 20 IS - 6 N2 - PURPOSE: Patients with clinically evident chronic venous insufficiency were evaluated to relate the degree of insufficiency and calf muscle pump dysfunction to venous ulceration. METHODS: Sixty-nine limbs in 55 patients with chronic venous insufficiency by Society for Vascular Surgery/International Society for Cardiovascular Surgery Classification were compared in three groups: classes 1 and 2 with no history of ulceration (19 limbs); class 3 with healed ulceration (20 limbs); and class 3 with active ulcers (30 limbs). Air plethysmography measurements of outflow fraction, venous volume, venous filling time, venous filling index, ejection fraction, ejection volume, residual volume fraction, and residual volume were made. In 62 of the 69 limbs, color-flow duplex ultrasonography was used to determine the pattern of reflux. RESULTS: The outflow fraction was normal in 84%, 75%, and 77% of nonulcerated, healed, and ulcerated limbs. The venous filling index was abnormal in most limbs (nonulcerated 95%, healed 90%, ulcerated 98%) but not significantly different among groups. Differences in calf muscle pump function were significant. Ulcerated limbs had significantly poorer ejection fractions (p = 0.0002) and greater residual volume fractions (p = 0.0006) than nonulcerated or healed limbs. By ultrasonography, deep and superficial vein incompetence was present in most limbs and was not statistically different among groups. Although venous insufficiency was not measurably different among groups, limbs with active venous ulcers had significantly poorer calf muscle pump function than those with healed ulcers or with no history of ulceration. CONCLUSION: Venous insufficiency is necessary but not sufficient to cause ulceration, and a deficiency of the calf muscle pump is significant to the severity of venous ulceration. SN - 0741-5214 UR - https://www.unboundmedicine.com/medline/citation/7990181/The_significance_of_calf_muscle_pump_function_in_venous_ulceration_ L2 - https://linkinghub.elsevier.com/retrieve/pii/0741-5214(94)90223-2 DB - PRIME DP - Unbound Medicine ER -