Vettorello GF, Gasbarro V, Mascoli F, Navarra G,
Occhionorelli S, Rubbini M, Cerreta G, Pozza E, Donini I.
["Simulated walking" in the duplex evaluation of the venous system. The clinical
and instrumental correlations.]
[Article in Italian]

Minerva Cardioangiol 1994 Dec;42(12):559-67

Istituto di Clinica Chirurgica e Terapia Chirurgica, Universita di Ferrara.

The goals of non-invasive duplex vascular diagnosis of the venous system of the
lower limbs are: 1) To make evaluation of the venous system during deambulation
feasible under physiological, pathological and post-surgical or elastocompressive
conditions. Moreover, any such evaluation must be achieved using a standardized,
easy, highly reproducibly method which is inexpensive and utilizes the diagnostic
instruments available. 2) To achieve detailed, selective localization of the
valvular and parietal dysfunctions at the basis of any reflux pathology. 3) To
identify and quantify venous flux and reflux during deambulation. The present
work gives the results achieved over the period of one year after a new method
simulating deambulation (Walk System 1 patented) was set up for several
utilizations, principally correlated to the use of conventional duplex scanning
in studying the venous system. The main purpose of the Walk System 1 is step
simulation to uncover the location and extent of venous disease. This application
test of: a pneumatic pump which compresses the calf to 100-120 mmHg in 0.3 sec
thus simulating muscolar pumping during deambulation; standard 40 mmHg
compression of the foot in order to rule out any hemodynamic involvement of the
foot pump venous system. We can use this pump in the hemodynamic component, a
part, during the step simulation, with synchronism with calf pump in TVP
prophylaxis or in vascular therapy; an easy-to-use application software able to
quickly pulsed Doppler data of flux and reflux by means of the flux and reflux
orthodynamic indices or with measures in ml/sec. The study was performed on 80
lower limbs in normal subjects in order to define the normality range and in 380
lower pathologic limbs. The study has yielded a clinical-instrumental correlation
between the hemodynamic data observed during inflation-deflation of the calf
cuff, positioning the pulsed Doppler sample volume in the saphenous vein in the
saphenous-femoral ostium zone and the underlying venous morphology. The results
have made it possible to determine physiological S-F reflux and to establish 4
pathological classes of orthodynamic S-F reflux, each class corresponding to a
specific range in the orthodynamic reflux index (class 0 = 0 < RI < 0.25; class 1
= 0.25 < RI < 2; class 2 = 2 < RI < 3.5; class 3 = 3.5 < RI < 6; class 4 = RI >
5) and to a particular morphological conditions.(ABSTRACT TRUNCATED AT 250 WORDS)