Prediction of the Biomechanical Effects of Compression Therapy on Deep Veins Using Finite Element Modelling

Abstract

Clinicians generally assume that Medical Compression Stockings (MCS) work by reducing vein luminal diameter and, in this way, help to prevent blood pooling. Conflicting results have been reported however in the case of lower leg deep veins which call into question this hypothesis. The purpose of this contribution is to study the biomechanical response of the main lower leg deep veins to elastic compression and muscle contraction with the objective of improving our current understanding of the mechanism by which MCS convey their benefits. The development of a finite-element model of a slice of the lower leg from MR images is detailed. Analysis of the finite-element model shows that the contribution of the MCS to the deep vein diameter reduction is rather small, and in fact negligible, compared to that of the contracting muscle (3 and 9% decrease in the vein cross-sectional area with a grade II compression stocking in the supine and standing positions respectively, while complete collapse was obtained at the end of muscle activation). A more accurate representation of the muscle activation is eventually proposed to study the effect of muscle contraction on a vein wall. The impact on the venous blood draining is discussed.

Prediction of the Biomechanical Effects of Compression Therapy by Finite Element Modeling and Ultrasound Elastography

“…Then, studies started to consider the deformation of veins in these models [8], [9], [13]. Recent studies [14] have shown that the biomechanical action and the benefits of elastic compression are different for deep veins and for superficial veins (see Fig. 1).…”

“…Indeed, at active muscle state, the intramuscular pressure in the tissues surrounding deep veins varies by range ten times larger than the pressure applied by MCS. The direct impact of elastic compression on the caliber of deep veins is then relatively limited, especially in the standing position [14]- [16]. The situation is different for 0018-9294 © 2014 IEEE.…”

Experimental Investigation of Pressure Applied on the Lower Leg by Elastic Compression Bandage

“…23,27 Numerous studies have proven the effect of compression therapy on venous and lymphatic system, 1,19,31 whether compression is performed with bandages or stockings. 5 The efficacy of the treatment mainly depends on the level of pressure which is applied on the limb.…”

Subject-Specific Computational Prediction of the Effects of Elastic Compression in the Calf

“…Indeed, it appears that the elastic compression has a significant effect on these veins, whereas the effect on deep veins is rather negligible compared to the effect of muscle contraction [14,15].…”

“…A review is presented in [10]. Previous biomechanical studies [12,13,14] highlighted the importance of inter-individual variations and the necessity to develop computational models on a patient-specific basis. This is the objective of the current chapter.…”