Prediction of Postoperative Improvement in Lower Limb Oedema after Endovenous Laser Ablation Using a Noninvasive Venous Pressure Measurement Device
Tomoeda H, Sawada K and Chihara S
Published on: 2022-12-16
Objectives: For the last few decades, venous function of the lower extremities has generally been evaluated with air plethysmography (APG), although in a recent large-scale study, the clinical usefulness of this metric has been questioned. In this study, we developed an innovative noninvasive venous pressure measuring device that was evaluated for its clinical utility.
Methods: Venous pressure of the great saphenous vein in the ankle of patients with varicose veins was measured three times continuously within 12 seconds of using our device one minute after standing rest and after a tiptoe exercise both before and after endovenous laser ablation (EVLA). The mean value of the venous pressure after the tiptoe exercise was divided by that after standing rest, and this value was used as an index for venous pump function (IVPF). The circumferential diameter of the ankle of each patient was measured before and after the EVLA procedure, and the difference (postoperative minus preoperative value) was used as an index for postoperative worsening of lower leg oedema. Thereafter, the correlation between venous pump function and leg oedema was evaluated.
Results: The venous pressure after standing rest was significantly decreased after the EVLA procedure compared to that before the procedure. The venous pressure after tiptoe exercise was significantly lower after the EVLA procedure than before the procedure. The IVPF after the procedure was significantly lower than that before the procedure. The receiver operating characteristic curve for evaluating the postoperative increase in circumferential diameter revealed that a preoperative IVPF greater than 1.057 was a suitable cut-off.
Conclusions: Our device can easily indicate postoperative improvements in venous pressure and venous pump function in a very short time and can be used to predict postoperative improvement in leg oedema, which has been difficult with other devices.