Venous Compliance in Great Saphenous Vein Incompetence: Pre- and Post-interventional Changes

Objective: Venous insufficiency is associated with histological changes and structural remodelling of the venous wall. The effects of these changes on global venous function remain uncertain. The aim was to evaluate venous compliance in patients with great saphenous vein (GSV) insufficiency before and after treatment by radiofrequency ablation (RFA) and in controls. Methods: Eleven patients (14 limbs) underwent endovenous RFA treatment for GSV incompetence. Duplex ultrasound and strain gauge plethysmography (SGP) were performed before and after RFA. SGP time (seconds) to reach 50% of maximum venous volume (T-50) with and without superficial occlusion was used to assess global venous reflux. Venous occlusion plethysmography was used to evaluate pre- and post-operative calf venous compliance. Venous compliance was also assessed in 12 age and sex matched controls. Results: Pre-operative calf venous compliance was lower in patients than in controls (p < .001). Post-operative calf venous compliance was reduced vs. pre-operative measurements (p < .002). The pre-operative reflux parameter T-50 improved from 8.0 +/- 2.0 seconds to 17.3 +/- 1.9 seconds (p < .001) after RFA. The post-operative T-50 without superficial occlusion was similar to pre-operative T-50 with superficial occlusion (17.1 +/- 2.5 vs. 17.3 +/- 1.9 seconds, p = .84). Conclusions: Calf venous compliance is reduced in patients with GSV insufficiency. Venous reflux parameters markedly improved after RFA, whereas venous compliance displayed a further reduction vs. the pre-operative state, implicating generalised changes in the lower limb venous vessel wall. (C) 2019 The Author(s). Published by Elsevier Ltd on behalf of European Society for Vascular Surgery.