VENOUS DYNAMICS IN LEG LYMPHEDEMA

To determine whether there is anatomical and/or functional impairment to venous return inpatients with lymphedema, we examined venous dynamics in 41 patients with unilateral leglymphedema. A Volometer® was used for computer analysis of leg volume, a color DuplexDoppler scanner was used to determine deep vein patency and skin thickness, and Airplethysmography was used to assess ambulatory venous pressure, venous volume, venous fillingindex and the ejection fraction.In the lymphedematous leg, volume and skin thickness were uniformly increased (126.4 ±21.3% and 156.9 ± 44.5%) (mean ± S.D.), respectively. The ambulatory venous pressure wasalso increased (134 ± 60.7%) as was the venous volume (124.5 ± 37.5%), and the venous fillingindex (134.5 ± 50.5%). The ejection fraction was decreased (94.9 ± 26.1%). Greater leg volumecorrelated with increased venous volume and venous filling index (values = 0.327, 0.241,respectively) and decreased ejection fraction (r = -0.133). Increased subcutaneous thicknesscorrelated with increased venous filling index and venous volume (r = 0.307, 0.126, respectively)and decreased ejection fraction (r = -0.202).These findings suggest that soft tissue edema from lymphatic stasis gradually impedesvenous return which in turn aggravates the underlying lymphedema.