LASER-DOPPLER FLUX IN THE VENOUS WALL

Objectives: To evaluate in vivo the perfusion of the venous wall in no rmal veins, varicose veins and in femoral veins of post-phlebitic limb s recording wall flux with laser Doppler flowmetry. As there is some e vidence that both structure and microcirculatory dynamic responses are altered in the abnormal vein wall, we also aimed to study the respons e of vein wall perfusion to locally induced vasodilatation following p apaverine infusion. Design: Open prospective study in patients with ve nous insufficiency and in patients undergoing coronary revascularizati on with a normal venous system. Setting: Cardiovascular Institute, Chi eti University, Pierangeli Clinic, Italy and Irvine Laboratory, St Mar y's Hospital, London, UK. Patients: Twenty-four normal long saphenous veins and 11 common femoral veins (35 normal veins, 35 subjects) and 4 2 varicose veins (42 patients). Measurements: Venous wall flux was mea sured on the external surface of normal long saphenous veins and commo n femoral veins. Measurements were also made on varicose veins before ligation of the sapheno-femoral junction. All measurements were made w hen at least three-quarters of the adventitia and periadventitia tissu e were still intact for a length of 3 cm. Results: Flux in the normal vein wall was higher (t=5.88; p<0.05) than in varicose veins and in ve ins of postphlebitic limbs. There was no difference in flux between va ricose veins and post-phlebitic veins. After intravenous papaverine in jection in a subgroup of eight normal and eight varicose veins, in the wall of normal veins there was a significant increase in flux (from 8 .5 (SD 5.1) units to 13.2 (SD 3.8) units; p<0.05) which was not observ ed in varicose veins. Conclusions: A higher vein wall perfusion was ob served in normal veins compared with varicose veins and postphlebitic limb veins. Greater vascular reactivity to intraluminal papaverine inj ection was observed in normal veins.