Belcaro GV, Nicolaides AN
Acute effects of intermittent sequential compression in venous hypertension.
J Cardiovasc Surg (Torino) 1993 Dec;34(6):493-7

Irvine Laboratory, Academic Surgical Unit, St Mary's Hospital Medical School, London, England.

Chronic venous hypertension produces microangiopathy which often progresses to
ulceration. It has been recently observed that intermittent sequential
compression (ISC) increases the rate of healing of venous ulcers. The aim of this
study was to investigate the effect of this form of therapy on the
microcirculation in limbs with venous hypertension. Skin blood flow at rest (RF)
was measured by laser Doppler flowmetry at the perimalleolar region at rest
(horizontal position) and on standing in 34 limbs with chronic venous
hypertension (17 with ulcerations) and 20 limbs of healthy volunteers. The
venoarteriolar response (VAR = the vasoconstrictory response on standing) was
also measured. Also 8 limbs with venous hypertension not treated with ISC were
studied to evaluate the effects of supine resting alone on the microcirculation.
Two treatment protocols were used. In Study 1 intermittent sequential compression
was applied for 30 minutes. Laser-Doppler measurements were performed at time 0
(before intermittent sequential compression) and after 30, 60 and 90 minutes. In
Study 2 intermittent sequential compression was applied for 60 minutes and
measurements were performed at time 0 and after 60 and 120 and 180 minutes. In
patients of Study 1 RF was 1.45 +/- 0.8, significantly higher than in normals (p
< 0.05) and the venoarteriolar response only 7%, significantly lower than in
normals. At the end of the compression period there was a marked change towards
normality as RF decreased (1.1 +/- 0.2) while the change in venoarteriolar
response was not significant. At 60 and 90 minutes the changes in RF were still
significant (p < 0.05) and the VAR was significantly increased (p <
0.05).(ABSTRACT TRUNCATED AT 250 WORDS)