Document Detail

Physiological reflux and venous diameter change in the proximal lower limb veins during a standardised Valsalva manoeuvre.
MedLine Citation:
PMID:  10329523     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: the aim of this study was to provide normal values for venous diameter at rest, and venous diameter and physiologic venous reflux during a standardised Valsalva manoeuvre. The impact of the patient's sex, body mass index (BMI), and family history was investigated. MATERIAL AND METHODS: eighty legs of 40 healthy volunteers were investigated in a supine position. The median age was 28 years (range 20-66 years). The common femoral vein (CFV), the proximal superficial femoral vein (SFV) and the proximal long saphenous vein (LSV) were investigated by duplex sonography. The following parameters were assessed: resting diameter (VDrest) and maximum diameter (VDmax) as well as reflux time (tr) during the Valsalva manoeuvre. The Valsalva manoeuvre was elicited by a forceful expiration into a tube system. The standard values used were a pressure of 30 mmHg, established within 0.5 seconds (s) and maintained over a time period of at least 3 s. RESULTS: mean VDrest and VDmax were 8.3+/-2.2 and 11.1+/-2.8 mm in the CFV, 5.9+/-1. 3 and 7.2+/-1.6 mm in the SFV and 3.5+/-0.9 and 4.3+/-1.4 mm in the LSV. Mean values for tr were 0.61+/-0.63 s in the CFV, 0.25+/-0.26 s in the SFV and 0.28+/-0.40 s in the LSV. A BMI >22.5 kg/m2 was associated with statistically significant larger values for VDrest and tr. If adjusted for BMI, tr in the SFV and the LSV did not differ by sex. For healthy subjects with first-degree relatives suffering from varicose veins (n=19), mean VDrest in the SFV as well as VD in the LSV was significantly larger (p=0.02, 0.05, respectively). Coefficients of variation for repeated measurements (VDrest, VDmax, tr) in the same segment varied between 3.3% and 16. 4% for the three investigated sites. CONCLUSIONS: normal values for VDrest and VDmax as well as reflux time during a standardised Valsalva manouevre were assessed in the proximal lower limb veins. The influences of BMI, sex and family history were investigated. The described standardised Valsalva manoeuvre led to highly reproducible results and can be recommended for further research projects or as a routine procedure for the assessment of venous reflux.
C Jeanneret; K H Labs; M Aschwanden; A Bollinger; U Hoffmann; K Jäger
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  17     ISSN:  1078-5884     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  1999 May 
Date Detail:
Created Date:  1999-07-23     Completed Date:  1999-07-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  398-403     Citation Subset:  IM    
Copyright Information:
Copyright 1999 W.B. Saunders Company Ltd.
Division of Angiology, University of Basel Medical School, 4031 Basel, Switzerland.
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MeSH Terms
Analysis of Variance
Body Mass Index
Leg / blood supply*,  ultrasonography
Middle Aged
Pilot Projects
Reference Values
Reproducibility of Results
Sex Characteristics
Ultrasonography, Doppler, Duplex / methods
Valsalva Maneuver / physiology*
Varicose Veins / genetics,  physiopathology
Veins / anatomy & histology*,  physiology*,  ultrasonography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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