Assessment of venous muscle pump function by ambulatory calf volume strain gauge plethysmography after surgical treatment of varicose veins: a prospective study of 21 patients.

A prospective study of the improvement in leg muscle pump function after radical surgery was performed for treatment of varicose veins. Venous muscle pump function was assessed in 21 patients with primary varicose veins by means of ambulatory strain gauge plethysmography immediately before surgery and 3 months and 60 months after surgical treatment of varicose veins. The physiologic documentation of the operative efficacy was provided by the mean venous reflux, which was reduced by 54% (p less than 0.001), and the mean expelled volume, which was increased by 58% (p less than 0.001). Initially, all patients had improved venous muscle pump function. This improvement was still present 60 months after surgery. At clinical assessment 3 months after surgery, it was noted that 90% of the patients were without residual varicose veins (p less than 0.01). Sixty months after surgery, 71% of the patients were without apparent varicose veins (p less than 0.05). Subjective symptoms had virtually disappeared 3 months after surgery (p less than 0.001) but were found to a variable extent in 80% of the patients at the 60-month control follow-up. It is concluded that ambulatory strain gauge plethysmography may quantitate the effect of surgery in patients with venous valvular incompetence; in addition to measurements of refilling time, it is able to measure the muscle-pump-generated expelled volume because of in-place electrical calibration.