Methods of evaluation and quantification of microangiopathy in high perfusion microangiopathy (chronic venous insufficiency and diabetic microangiopathy)

Noninvasive tests have been developed to provide qualitative and quantitati ve information that can offer answers to most questions posed in venous dis eases. While duplex scanning is used to assess the macrocirculation, microc irculatory methods assess and quantify venous microangiopathy. Laser Dopple r flowmetry is used to assess tissue viability and perfusion. Transcutaneou s PO2 and PCO2 measurements are used to study venous hypertension, and stra in-gauge plethysmography (SGP) is used to assess capillary filtration. In v enous hypertension fluid filtration into the extracapillary compartment is increased. The increase in filtration is associated with a decreased venoar teriolar response. To quantify capillary filtration two methods have been d eveloped: venous occlusion plethysmography and rate of ankle swelling, Thes e methods quantify filtration into the extracapillary compartment and there fore are an indication of the formation of edema, which is the most frequen t sign of venous hypertension. Other methods such as the vacuum suction cha mber and the edema tester can be used to assess changes due to treatment in chronic venous hypertension. These methods have been used and validated in several experimental and clinical studies. The techniques described in thi s article were used in controlled environmental conditions. Results were co nsistent with clinical problems and data from previous studies from our gro up and from data from other investigators.