Study of the Tendency to Edema Formation Associated With Incompetence of the Valves of the Communicating Veins of the Leg. Oxygen Tension of the Blood Contained in Varicose Veins

Holling, H. E.; Beecher, Henry K.; Linton, Robert R.

doi:10.1172/jci100980

Cited by 38 publications

(13 citation statements)

References 5 publications

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“…It was noted previously that the oxygen tension of venous blood was raised in the legs of subjects with venous insufficiency (Blalock 1929, Holling et al 1938, Fontaine 1957, and this was postulated to be due to arteriovenous shunts (Pratt 1949, Brewer 1950) which led to diminished tissue perfusion. However, in spite of searches, no shunts could be shown (Lindemayr et al 1972, Hehne et al 1974.…”

Section: Discussionmentioning

confidence: 96%

“…Early concepts suggested that stagnation of blood in the affected lower limbs led to anoxia and ulceration of the overlying skin (Homans 1917). Subsequent studies have shown that blood flow in affected limbs is greater than that of normal limbs (Piulachs & VidalBarraquer 1953) and that oxygen tension in the femoral vein is also increased (Blalock 1929, Holling et al 1938, Fontaine 1957. The existence of abnormal arteriovenous communications was put forward to explain this paradox (Pratt 1949, Brewer 1950.…”

Section: Introductionmentioning

confidence: 99%

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Skin Oxygen Tension in Venous Insufficiency of the Lower Leg

1985

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Summary: Tissue anoxia has for long been invoked as a cause of venous leg ulcers, and recently it has been suggested that pericapillary fibrin prevents the diffusion of oxygen in the skin. In the present study direct measurements of skin oxygen levels on the lower leg were made using a transcutaneous oxygen monitor. In the recumbent position mean oxygen tensions were higher in patients than in controls, thus disproving the existence of any block to oxygen diffusion. In both groups there was a fall in oxygen tension to low levels on standing as a result of the normal reflex vasoconstrictor response to increased venous pressure. Exefcise produced a marked rise in skin oxygen tension in normal legs but not in those affected by venous insufficiency. In normal subjects exercise reduces venous pressure, thus removing the stimulus for reflex vasoconstriction. In patients with defective valves, the venous pressure remains high during exercise and reflex vasoconstriction persists. It is concluded from this study that the sustained low skin oxygen tension in the upright position even during exercise is responsible for leg ulcer formation associated with venous insufficiency. Normal legs are protected by a rise in skin oxygenation during exercise.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Skin Oxygen Tension in Venous Insufficiency of the Lower Leg

1985

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“…However, findings from these studies have been inconsistent as some studies demonstrated a lower oxygen content in blood from varicose compared to non-varicose veins [19,20,21], whereas others showed no significant differences [22,23,24,25,26]. Paradoxically, some studies even reported higher oxygen content in blood of varicose than non-varicose veins [22,23,27,28,29]. Numerous factors may have contributed to these variations.…”

Section: Measuring Luminal Blood Oxygenation In Varicose Veinsmentioning

confidence: 99%

“…Interestingly, in non-dependent (lying) positions, the oxygen content of blood from varicose veins appeared to be similar or even higher than that of non-varicose veins. In the dependent positions, the oxygen content of blood from both varicose and non-varicose veins decreased, but the reduction may be greater in blood from varicose veins [22,23]. …”

Section: Measuring Luminal Blood Oxygenation In Varicose Veinsmentioning

confidence: 99%

Venous Hypoxia: A Poorly Studied Etiological Factor of Varicose Veins

et al. 2010

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Venous hypoxia has long been postulated as a potential cause of varicosity formation. This article aimed to review the development of this hypothesis, including evidence supporting and controversies surrounding it. Vein wall oxygenation is achieved by oxygen diffusing from luminal blood and vasa vasorum. The whole media of varicosities is oxygenated by vasa vasorum as compared to only the outer two-thirds of media of normal veins. There was no evidence that differences exist between oxygen content of blood from varicose and non-varicose veins, although the former demonstrated larger fluctuations with postural changes. Studies using cell culture and ex vivo explants demonstrated that hypoxia activated leucocytes and endothelium which released mediators regulating vein wall remodelling similar to those observed in varicosities. Venoactive drugs may improve venous oxygenation, and inhibit hypoxia activation of leucocytes and endothelium. The evidence for hypoxia as a causative factor in varicosities remains inconclusive, mainly due to heterogeneity and poor design of published in vivostudies. However, molecular studies have shown that hypoxia was able to cause inflammatory changes and vein wall remodelling similar to those observed in varicosities. Further studies are needed to improve our understanding of the role of hypoxia and help identify potential therapeutic targets.

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“…The principal manifestation is increased venous pressure (16, 51,65,66). This pressure is transmitted to the venous capillaries and diminishes arterial capillary influx: chronic anoxia results with undernourishment of tissues (67)(68)(69).…”

Section: Incidencementioning

confidence: 99%

The Postphlebitic Syndrome: Discussion of Surgical Treatment

Ensenat

1953

Angiology

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Study of the Tendency to Edema Formation Associated With Incompetence of the Valves of the Communicating Veins of the Leg. Oxygen Tension of the Blood Contained in Varicose Veins

Cited by 38 publications

References 5 publications

Skin Oxygen Tension in Venous Insufficiency of the Lower Leg

Skin Oxygen Tension in Venous Insufficiency of the Lower Leg

Venous Hypoxia: A Poorly Studied Etiological Factor of Varicose Veins

The Postphlebitic Syndrome: Discussion of Surgical Treatment

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