VENOUS PUMP OF THE CALF - A STUDY OF VENOUS AND MUSCULAR PRESSURES

Purpose: Little data are available concerning the relation between the muscular pumping mechanism and the variation of superficial and deep venous pressure during normal action of the calf pump; therefore we un dertook this study to determine the pressure values in three compartme nts of the calf and in the deep and the superficial venous system and to establish correlation between muscular and venous pressure. Methods : Nine healthy young women with a mean age of 23 years (range 19 to 28 years) were examined. In the same calf, a muscular catheter was place d in the deep posterior compartment (DPC), in the superficial posterio r compartment (SPC), and in the anterior tibial compartment (ATC), and a vascular catheter was placed in the popliteal vein and in the great er saphenous vein (GSV). The five lines of pressure were simultaneousl y recorded in the following situations: at rest, during Valsalva maneu ver, foot flexion, and foot extension. The situation was studied with the patient in the following positions: decubitus, sitting, standing, and squatting. A final continuous recording was carried out after the patient had been walking for 5 minutes. Results: Mean values with stan dard errors of muscular and venous pressure were established in each s ituation. At rest and during Valsalva maneuver, the muscular pressures did not vary, whereas venous pressures increased significantly when t he patient was sitting and standing. On the other hand, squatting was associated with a rise in the muscular and vein pressures. Foot flexio n entailed a significant increase in the ATC pressure and a rise in th e GSV pressure, whereas foot extension caused the DPC pressure to rise without venous pressure modifications. Walking was associated with an alternating increase in the DPC, SPC, GSV and popliteal vein pressure s when the foot was compressed to floor followed by a significant decr ease when the foot pressure was released. Conclusions: The variations in the deep and superficial venous pressures when the patient is sitti ng and standing both at rest and during Valsalva maneuver are not asso ciated with an increase in the muscular pressure. On the contrary, dur ing foot movements, the ATC and the DPC are responsible for superficia l vein pressure variations without modifications of the SPC pressure.