The choice of elastic compression knitwear for decompensated chronic venous insufficiency
DOI:
https://doi.org/10.14739/mmt.2026.2.338765Keywords:
microcirculation, trophic ulcer, varicose disease, postthrombotic syndrome, angiosome, regional perfusion indexAbstract
Aim. To improve the results of treatment of patients with decompensated forms of chronic venous insufficiency, it is necessary to study changes in the volume velocity in the femoral artery and vein, changes in microcirculation in the lower third of the leg, and the severity of pain syndrome depending on the degree of external compression.
Materials and methods. The study included 36 patients with decompensated forms of chronic venous insufficiency, divided into two groups. The first group consisted of 15 patients with varicose disease (VD; 9 women, 6 men; mean age 56.0 ± 5.7 years). The second group included 21 patients with post-thrombotic syndrome (PTS; 12 women, 9 men; mean age 58.5 ± 6.4 years). All patients underwent ultrasound examination of the femoral vessels to determine arterial (AFV) and venous (VFV) blood flow velocity. Microcirculation was assessed by transcutaneous monitoring of oxygen (tcpO2) and carbon dioxide (tcpCO2) tension on the dorsum of the foot, with calculation of the regional perfusion index (RPI) according to the angiosome theory. Pain intensity was assessed using the CIVIQ-20 scale. The study was performed sequentially using compression stockings of classes I–IV.
Results. In patients of both groups, the use of class III and IV compression was accompanied by a statistically significant decrease in AFV and VFV, a critical drop in tcpO2 (to 61.2 ± 1.3 mmHg in VD and 54.4 ± 1.2 mmHg in PTS), an increase in tcpCO2 (to 56.2 ± 0.9 mmHg and 60.2 ± 0.7 mmHg, respectively), and an increase in pain syndrome (up to 4 points on the CIVIQ-20 scale). In patients with PTS, even class I–II compression resulted in a more pronounced decrease in microcirculatory parameters and more intense pain compared to the VD group. The RPI in patients with PTS without compression was below normal: by 17.3 % in the anterior tibial angiosome and by 23.2 % in the posterior tibial angiosome.
Conclusions. The use of elastic compression classes III and IV in patients with decompensated chronic venous insufficiency is accompanied by a statistically significant inhibition of arterial blood flow, a critical decrease in transcutaneous oxygen tension (tcpO2), an increase in carbon dioxide tension (tcpCO2), and causes intense pain, making its use potentially harmful to tissue perfusion.
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