GASTROCNEMIUS VEIN – DIAMETERS DECREASE UNDER COMPRESSION STOCKINGS

Purpose: Gastrocnemiusvein diameters are measured in healthy subjects without and trough a compression stocking. The goal of our study was to investigate whether the diameters in antero-posterior or in latero-medial crossection change under compression pressures of class II (CEN) stockings.

Methods and Materials: 40 legs of 20 healthy subjects (13 m, 7 f) with a median age of 32.2 years (21.6–52.5) were investigated in standing position at room temperature (20? C) between 2 and 7 pm. The following vein segments were tested for venous reflux: the common femoral vein, the superficial femoral vein, the great saphenous vein, the small saphenous vein, the popliteal vein, the posterior tibial vein and the gastrocnemius muscle – veins. As an inclusion criteria no significant venous reflux (refluxtime <0.5s) was detectable. Venous diameters of 2 gastrocnemius muscle – veins (medial gastrocnemius muscle) in a defined distance from the popliteal area were measured without and again while wearing compression stockings class II, with a duplexsonography device ATL HDI 3500. Pressure – measurement to control sufficient compression of the stokings were performed, mean values at d level (proximal calf) amounted to 18.9mmHg (±3.5). The venous diameters in anterior – posterior (ap) and in medio – lateral (ml) cross – section were assessed and then measured offline by means of a computer program (NIH image 1.6). The results were compared intraindividually using the paired t-test.

Results: Mean (±SD) of the venous diameter in ap cross – section without and with compression were 4.5 (±1.3) and 4.0 (±1.4)mm respectively and in ml cross – section 4.9 (±1.5) and 4.6 (±1.6)mm. Venous diameter – changes in % of the diameter without compression in ap and in ml cross – section were 13.4% (±12.2) and 14.4% (±13.7) respectively. 64 of 80 diameters were smaller under compression in ap and 52 of 80 in ml cross – section. Intraindividual testing showed significant difference in ap diameter change (p<0.0001) as well as in ml cross-section (p=0.007).

Conclusions: Although small differences are seen, the antero – posterior and medio – lateral diameter of the medial gastrocnemius muscle – veins decrease under compression – stocking class II in healthy volunteers. Further studies have to investigate the clinical impact of gastrocnemius muscle – vein width as well as the influence of compression stockings in symptomatic patients