MICROANGIOPATHY IN CHRONIC VENOUS INSUFFICIENCY BEFORE AND AFTER SCLEROTHERAPY AND COMPRESSION TREATMENT - RESULTS OF A ONE-YEAR FOLLOW-UP-STUDY

Objective: To characterize microangiopathy in patients with chronic ve nous insufficiency (CVI) of a moderate to severe stage and to evaluate improvement of the microcirculatory parameters after sclerotherapy of incompetent perforators and compression therapy. Design: Fluorescence videomicroscopy (Na-fluorescein), laser Doppler fluxmetry and tcPO2 m easurements (43-degrees-C) at the medial ankle in healthy controls and patients. Laser Doppler flux and tcPO2 were recorded in supine and si tting position in order to evaluate postural vasoconstriction. The mea surements were repeated 6 and 12 months after sclerotherapy of incompe tent perforators (Polidocanol 40 mg/ml) and compression therapy by bel ow-knee class II or III stockings (Sigvaris(R)). Setting: Department o f Internal Medicine, Angiology Division, University Hospital, Zurich, Switzerland. Patients, participants: 15 healthy subjects (15 legs, mea n age 53.3 years) and 15 patients with CVI of a moderate to severe sta ge (17 legs, mean age 56.8 years). Results: Microangiopathy in CVI is characterized by significantly enlarged, elongated and dilated capilla ries with increased diameters of the pericapillary spaces ('halos'). S ingle capillaries may be thrombosed. Laser Doppler flux is increased a nd tcPO2 is decreased. After therapy, there was a trend to decreased l aser Doppler flux and an increase in tcPO2, but the differences were n ot statistically significant. Capillary thromboses were no longer dete cted. Mean halo diameters tended to decrease, but this difference was not statistically significant. Conclusions: Microangiopathy in CVI is characterized by morphological and functional changes. Beneficial chan ges induced by therapy develop slowly and emphasize the importance of long-lasting treatment.