Avaliação do efeito da meia elástica na hemodinâmica venosa dos membros inferiores de pacientes com insuficiência venosa crônica

Abstract

The venous chronic insufficiency presents signals and symptoms produced by the venous hypertension, that result in functional and structural alterations of the vein. The elastic stockings are considered the best clinicai treatment of the VCI in the lower limbs. The mechanism of action of the elastic stockings has been widely discussed in the literatura using the venous hemodynamic analysis to assess the efficacy of them. The objective of this study is to evaluate the effect of the use of medicai compression stockings (Strong compression KendallR - 30/40mmHg). Sixteen patients in 29 limbs (3 men and 13 women, [mean age 44.3 years]). Nineteen limbs had primary venous insufficiency; 10 limbs had secondary venous insufficiency; 12 limbs in CEAP 4 and 17 in CEAP 5, to assess the venous hemodynamics effects using Air Plethysmography (APG) SDV 2000 (Angiotec - Belo Horizonte - Brasil). The measurements made without stockings, when using them, and one hour after their removal. Color duplex scanning was performed to determine the reflux. Patients with ankle-brachial index (< 0.8) and those unable to perform the APG were excluded. The stockings have been more efficient to control the W, VFI and EF in patients with primary CVI. When the patients were wearing stockings, the VFI had a significant decrease, T0- 6.03 mL/s to T1- 4.84 mL/s (p<0,0000). The W decreased from T0- 137.11 mL to T1 - 104.52 mL (p= 0.004). Comparing the moments T0- 64.55% and T1- 71.24% (p=0.0126) we concluded that there wasan increase in the EF while the stockings were on. The differences found in the RVF were statistically nonsignificant. Medicai compression stockings are effective, reducing the venous reflux, improving the venous volume and ejection fraction. We concluded that the beneficiai effects are presented only when the stockings are on.