Assessment of lower extremity venous function using foot venous pressure measurement

Background: Measurement of foot venous pressure (FVP) is useful for evaluating chronic venous insufficiency (CVI) functionally, because CVI always causes venous hypertension. In the present study, the various FVP parameters were analysed according to the new classification of venous disorders based on clinical, aetiological, anatomical and pathophysiological data (the CEAP classification). Methods: During the past 7 years, a total of 257 legs in 196 consecutive patients with CVI have been studied. The following FVP parameters were assessed: the percentage decrease in pressure from rest with manual calf compression, the rate of increase of pressure during 4s after compression (4SR) and the time to 50 per cent recovery of pressure (RT 50 ) after release of compression. Results: The incidence of skin changes due to venous stasis increased as the percentage pressure drop and RT 50 fell. In addition, a pressure drop of less than 72 per cent and an RT 50 of less than 20 s could detect legs with skin changes with a sensitivity of 76 per cent and a specificity of 62 per cent. In legs with primary varicose veins, pressure drop, 4SR and RT 50 values deteriorated in proportion to the severity of the associated deep venous reflux. Conclusion: FVP parameters correlate well with the severity of clinical manifestations and venous reflux, and could be used quantitatively to evaluate the severity of CVI.