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Relationship between medical compression and intramuscular pressure as an explanation of a compression paradox.
MedLine Citation:
PMID:  24609618     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Using standing magnetic resonance imaging (MRI), we recently showed that medical compression, providing an interface pressure (IP) of 22 mmHg, significantly compressed the deep veins of the leg but not, paradoxically, superficial varicose veins.
OBJECTIVE: To provide an explanation for this compression paradox by studying the correlation between the IP exerted by medical compression and intramuscular pressure (IMP).
MATERIAL AND METHODS: In 10 legs of five healthy subjects, we studied the effects of different IPs on the IMP of the medial gastrocnemius muscle. The IP produced by a cuff manometer was verified by a Picopress® device. The IMP was measured with a 21G needle connected to a manometer. Pressure data were recorded in the prone and standing positions with cuff manometer pressures from 0 to 50 mmHg.
RESULTS: In the prone position, an IP of less than 20 did not significantly change the IMP. On the contrary, a perfect linear correlation with the IMP (r = 0.99) was observed with an IP from 20 to 50 mmHg. We found the same correlation in the standing position.
CONCLUSION: We found that an IP of 22 mmHg produced a significant IMP increase from 32 to 54 mmHg, in the standing position. At the same time, the subcutaneous pressure is only provided by the compression device, on healthy subjects. In other words, the subcutaneous pressure plus the IP is only a little higher than 22 mmHg-a pressure which is too low to reduce the caliber of the superficial veins. This is in accordance with our standing MRI 3D anatomical study which showed that, paradoxically, when applying low pressures (IP), the deep veins are compressed while the superficial veins are not.
Authors:
J-F Uhl; J-P Benigni; A Cornu-Thenard; J Fournier; E Blin
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-3-7
Journal Detail:
Title:  Phlebology / Venous Forum of the Royal Society of Medicine     Volume:  -     ISSN:  1758-1125     ISO Abbreviation:  Phlebology     Publication Date:  2014 Mar 
Date Detail:
Created Date:  2014-3-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9012921     Medline TA:  Phlebology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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