PMID- 24268516
OWN - NLM
STAT- MEDLINE
DCOM- 20140306
LR  - 20140113
IS  - 1532-2165 (Electronic)
IS  - 1078-5884 (Linking)
VI  - 47
IP  - 1
DP  - 2014 Jan
TI  - Quantifying the degree graduated elastic compression stockings enhance venous 
      emptying.
PG  - 75-80
LID - S1078-5884(13)00652-7 [pii]
LID - 10.1016/j.ejvs.2013.10.020 [doi]
AB  - OBJECTIVES: Graduated elastic compression (GEC) stockings reduce reflux and 
      venous volume but their performance on augmenting venous return is unproven. The 
      aim of this study was to quantify the ability of stockings to increase venous 
      outflow from the leg. DESIGN: A prospective study comparing venous emptying 
      without compression, versus class 1 (18-21 mmHg) and class 2 (23-32 mmHg) 
      compression, using air-plethysmography (APG). METHODS: The right legs of 20 
      healthy subjects were studied supine. A 12-cm thigh-cuff was inflated in 10 mmHg 
      steps from 0 to 80 mmHg while the corresponding increase in calf volume was 
      recorded using the APG sensor calf-cuff. At the 80 mmHg plateau, the thigh-cuff 
      was released suddenly to measure the unrestricted venous emptying. Venous return 
      was assessed by: (a) identifying the incremental thigh-cuff pressure causing the 
      maximal incremental increase in calf volume (IPMIV); (b) measuring the percentage 
      reduction in calf volume in 1 second following thigh-cuff release - outflow 
      fraction (OF); (c) time to empty 90% of the venous volume - venous emptying time 
      (VET90). RESULTS: Median and inter-quartile range (IQR) baseline values of IPMIV, 
      OF, and VET90 without compression were 20 mmHg (range: 20-30 mmHg), 44% (39-50%) 
      and 13 seconds (8.8-15.9 seconds), respectively. These improved significantly 
      with all stockings. The application of any stocking raised the median IPMIV by 30 
      mmHg. The change from a class 2 stocking compared with no stocking versus the 
      change from a class 1 stocking to no stocking had a more pronounced effect (p < 
      .005). After sudden thigh-cuff deflation, the venous emptying was 41-45% greater 
      and 9-10 seconds faster with all stockings (p < .005). CONCLUSIONS: This is the 
      first study to quantify the venous return of below-knee GEC stockings. 
      Assessments of stockings in augmenting venous return may be of use as a way of 
      optimising compression for individual patients unresponsive to standard 
      conservative treatment.
CI  - Copyright (c) 2013 European Society for Vascular Surgery. Published by Elsevier 
      Ltd. All rights reserved.
FAU - Lattimer, C R
AU  - Lattimer CR
AD  - Josef Pflug Vascular Laboratory, Ealing Hospital, Southall, UK; Imperial College, 
      London, UK. Electronic address: c.lattimer09@imperial.ac.uk.
FAU - Kalodiki, E
AU  - Kalodiki E
AD  - Josef Pflug Vascular Laboratory, Ealing Hospital, Southall, UK; Imperial College, 
      London, UK.
FAU - Kafeza, M
AU  - Kafeza M
AD  - Josef Pflug Vascular Laboratory, Ealing Hospital, Southall, UK; Imperial College, 
      London, UK.
FAU - Azzam, M
AU  - Azzam M
AD  - Josef Pflug Vascular Laboratory, Ealing Hospital, Southall, UK; Imperial College, 
      London, UK.
FAU - Geroulakos, G
AU  - Geroulakos G
AD  - Josef Pflug Vascular Laboratory, Ealing Hospital, Southall, UK; Imperial College, 
      London, UK.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20131030
PL  - England
TA  - Eur J Vasc Endovasc Surg
JT  - European journal of vascular and endovascular surgery : the official journal of 
      the European Society for Vascular Surgery
JID - 9512728
SB  - IM
MH  - Adult
MH  - Aged
MH  - Blood Flow Velocity
MH  - Elasticity
MH  - Equipment Design
MH  - Healthy Volunteers
MH  - *Hemodynamics
MH  - Humans
MH  - Lower Extremity/*blood supply
MH  - Male
MH  - Middle Aged
MH  - Pilot Projects
MH  - Plethysmography
MH  - Prospective Studies
MH  - Regional Blood Flow
MH  - *Stockings, Compression
MH  - Supine Position
MH  - Transducers, Pressure
MH  - Veins/physiology
MH  - Young Adult
OTO - NOTNLM
OT  - Air-plethysmography
OT  - Chronic venous disorder
OT  - Compression stockings
OT  - Graduated elastic compression
OT  - Venous elastic recoil
OT  - Venous emptying
OT  - Venous outflow
OT  - Venous return
EDAT- 2013/11/26 06:00
MHDA- 2014/03/07 06:00
CRDT- 2013/11/26 06:00
PHST- 2013/06/23 00:00 [received]
PHST- 2013/10/22 00:00 [accepted]
PHST- 2013/11/26 06:00 [entrez]
PHST- 2013/11/26 06:00 [pubmed]
PHST- 2014/03/07 06:00 [medline]
AID - S1078-5884(13)00652-7 [pii]
AID - 10.1016/j.ejvs.2013.10.020 [doi]
PST - ppublish
SO  - Eur J Vasc Endovasc Surg. 2014 Jan;47(1):75-80. doi: 10.1016/j.ejvs.2013.10.020. 
      Epub 2013 Oct 30.