Generalized changes in venous distensibility in postthrombotic patients

Introduction: In situ biomechanical properties of peripheral large veins were compared between asymptomatic young patients who had previously unilateral femoro-popliteal deep venous thrombosis (DVT) and age-matched, healthy controls; the aim of this study was to assess local or generalized alterations of venous watt biomechanics in postthrombotic patients. Patients and methods: Inner diameters of both common femoral veins, right axillary vein, and right internal jugular veins were measured in two directions by uttrasonography. Venous pressure was altered by posture changes (standing and tying) and by application of graded and controlled Valsava. Ten postthrombotic young patients without any symptoms and 11 age-matched control subjects were included. Results: In postthrombotic patients, both the affected and unaffected common femoral vein diameters and capacities were larger at tow transmural pressures than those for the control group, but they demonstrated significantly less distensibitity when higher pressures were applied. Similarly, in the internal jugular vein, capacity without Vatsalva was significantly higher in postthrombotic patients and distensibility was reduced (statistically significant in the erect position). Pressure-induced changes in axillary vein diameter were negligible. Conclusions: In situ diameter and capacity changes, and in situ distensibility of the femoral veins on both sides (i.e., the side of previous thrombosis as well as the disease free side) and of the jugular veins are reduced in the young DVT patients compared to veins of the age-matched, healthy controls. The pathophysiotogicat mechanism of generalized venous watt changes in these young DVT patients remains unknown. (c) 2005 Elsevier Ltd. All rights reserved