The Feasibility of Underwater Computerised Strain Gauge Plethysmography and the Effects of Hydrostatic Pressure on the Leg Venous Haemodynamics.

BACKGROUND: Strain gauge plethysmography (SGP) is employed to evaluate venous drainage of the lower leg. METHODS: In this study, SGP was used to evaluate the effects of the hydrostatic pressure (HP) of water on venous volume (VV), expelled volume, and ejection fraction (EF) in 22 healthy legs before and during immersion in water. RESULTS: HP reduced VV by 100% and even more during underwater (UW) exercise, making calculation of the UW EF possible. DISCUSSION: UW SGP is feasible and indicates that HP improves venous haemodynamics. This study suggests that including UW leg exercise in the rehabilitation protocols of patients with chronic venous disease may be useful. KEYWORDS: Strain gauge plethysmography, Underwater compression, Underwater ejection fraction, Underwater venous volume.

Refining diagnosis and management of chronic venous disease: Outcomes of a modified Delphi consensus process.

Chronic venous disease (CVD) is a common condition with major health consequences that is associated with poor long-term prognosis, significant socioeconomic impact, disabling symptoms and reduced quality of life. To provide practical guidance for diagnosis and management of CVD, a Delphi panel of 5 experts in steering committee and 28 angiologists/vascular surgeons met with the major aim of providing a supplement for established national and international guidelines. A total of 24 statements were voted upon in two rounds, of which consensus was reached on 22 statements, indicating a high level of overall agreement. Consensus was reached on 7 of 8 statements relative to diagnosis (CEAP classification, diagnostic tools, QoL assessment, diagnostic imaging) and on 15 of 16 statements on management (conservative treatments, compressive therapy, pharmacological therapy, surgical treatment). The results of the consensus reached are discussed herein from which it is clear that diagnostic and management approaches utilising personalised therapies tailored to the individual patient should be favoured. While it is clear that additional studies are needed on many aspects of diagnosis and management of CVD, the present Delphi survey provides some key recommendations for clinicians treating CVD that may be useful in daily practice.