DIAGNOSIS OF BLOOD REFLUXES IN THE PEDAL VEINS AND MECHANISMS OF INFRAMALLEOLAR VENOUS INSUFFICIENCY

B.S. Sukhovatykh, P.M. Nazarenko, L.N. Belikov, O.A. Rodionov, S.A. Abramova, A.N. Shcherbakov
Chair of Surgical Diseases №2, Kursk State Medical University,
Kursk, Russia

Two original methods of phlebographic examination were used to study the mechanisms of chronic inframalleolar venous insufficiency. The study accrued 139 patients presenting with varicosity. The pathologic action of blood refluxes in the superficial and communicating veins was explored by means of distal phlebography with injection of a contrast medium into the superficial plantar veins by catheterization of the intercapitate vein through an incision made on the dorsum pedis in the first interdigital space. The propagation of blood reflux in the deep veins was studied at the height of the Valsalva test by retrograde talocrural phlebography with injection of a contrast medium into the posterior tibial veins through the straight communicating vein located beyound the medial ankle. Chronic inframalleolar venous insufficiency is consequent on ectasia of the deep plantar veins. Body mass transfer from one leg to the other during walking gives rise to periodic compression of the in the plantar veins and to the penduliform blood movement in the perforating and superficial veins of the dorsum pedis, which manifests by the compensated or subcompensated disease course. The passing over to the decompensated course requires an additional blood supply from the deep veins of the calf to the deep plantar veins. Blood reflux in the deep veins potentiates the pathologic action of refluxes in the superficial and communicating veins whereby upsetting the microcirculatory processes and leading to the formation of trophic disorders in soft tissues of the foot.

KEY WORDS: chronic inframalleolar venous insufficiency, diagnosis, mechanisms of development.

P. 40-47

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