Postural Microvascular Reactivity in Chronic Venous Insufficiency

Abstract

Objective: To investigate microcirculatory functional abnormalities in non-ulcerated limbs with chronic venous insufficiency (CVI). Design: A case-control study. Setting: Outpatient clinic of a university hospital. Materials: Laser-Doppler was used to evaluate skin blood flow and the veno-arteriolar response (VAR) in 12 limbs with perimalleolar oedema and venous dilatation (CVI stage I), 12 with lipodermatosclerosis and hyperpigmentation (CVI stage II) and 12 healthy limbs. Resting flow (RF), blood volume and velocity were evaluated with the patient supine. After 2 min in the sitting position, blood flow (SF) was determined and the VAR was calculated. Main results: Compared with controls, blood volume was significantly increased and velocity reduced ( p<0.05) in both groups; RF and SF were significantly increased ( p<0.05) and the VAR was significantly reduced in stage II CVI patients. Conclusion: Venous microangiopathy and impaired orthostatic reactivity, as indicated by the alteration in the VAR, are present in non-ulcerated limbs with CVI.