The relationship between the clinical severity of chronic venous insufficiency and the calf muscle pump: A cross-sectional study.

PURPOSE: To investigate the connection between the clinical severity of chronic venous insufficiency (CVI) and the biomechanics of the calf muscle pump (CMP). MATERIAL AND METHODS: Through a cross-sectional observational study, we analyzed women on the age range between 30 and 80 years with chronic venous insufficiency, stratified according to the clinical classification. Ninety-nine women were assessed and classified into groups with different levels of severity: C1 (n = 22); C2 (n = 22); C3 (n = 22); C4 (n = 22); C5 (n = 8); C6 (n = 3). The main purpose was to investigate the strength of the calf muscle pump through total work (TW) and peak torque (PT), and the range of motion (ROM) of the ankle joint. For a secondary analysis, the fatigue index was assessed. All results were run through the Humac®/NORMT isokinetic dynamometer to obtain the data. RESULTS: Our findings pointed out that as the clinical severity of CVI increases, there is a reduction on the PT, the TW, the maximum active ROM and the ROM at 120°/sec. As severity increased, there was a reduction of 24Nm in the TW at 30°/sec.and a reduction of 3Nm in the PT at 30°/sec. OUTCOMES: When increased, clinical severity of CVI may trigger downgrading in the strength of the CMP and the ROM in the ankle. These findings are of relevance to the clinician, since through these findings, individuals with venous insufficiency may be treated more precisely for each classification.

Sugarcane biopolymer patch in femoral vein angioplasty on dogs.

PURPOSE: To evaluate the use of the sugarcane biopolymer membrane in femoral vein patch angioplasty on dogs. METHODS: Eight dogs were submitted to bilateral femoral vein patch angioplasty with a sugarcane biopolymer membrane patch on one side and an expanded polytetrafluoroethylene (e-PTFE) patch on the contralateral side. This research was performed at Experimental Surgical Research Laboratory of the Centro de Ciências da Saúde at Universidade Federal de Pernambuco. The dogs underwent new surgery at 180 days after the patch angioplasty in order to harvest the femoral vein. All the animals were evaluated by clinical examination, measure of femoral vein diameter, venogram, and Doppler fluxometry. The material harvested was sent for histologic study. Each animal served as its own control. RESULTS: In all veins of both groups, there were no cases of infection, rupture, or pseudoaneurysm formation and thrombosis. In both groups, a chronic inflammatory reaction was observed, with lymphocytes, neutrophils, and fibrosis in the outer surface of the patches. Fibrosis was seen in the inner surfaces of all the patches. In e-PTFE patches, invasion by fibroblasts occurred. CONCLUSIONS: The sugarcane biopolymer membrane can be used as a patch in femoral vein angioplasty on dogs. CLINICAL RELEVANCE: The sugarcane biopolymer membrane is easily synthesized with a low cost of production. This membrane has been used in many areas of experimental surgery as in the healing of skin wounds, in urinary reconstruction, in reconstruction of tympanic membrane, and as an arterial substitute, but there is no report of its use as a vein substitute. In order to evaluate the possibility of using the sugarcane biopolymer membrane in venous reconstructive surgery, this study analyzed its utilization in femoral vein patch angioplasty.