Noninvasive measurement of venous wall deformation induced by changes in transmural pressure shows altered viscoelasticity in patients with chronic venous disease

Abstract Objective The noninvasive measurement of venous wall deformation induced by changes in transmural pressure may allow assessing viscoelasticity and differentiating normal from diseased veins. Methods In 57 patients with limbs in C1S, C3, or C5 CEAP category of chronic venous disease (CVD) and 54 matched healthy controls, we measured with ultrasonography the changes in cross-sectional area of the small saphenous vein and of a deep calf vein in the supine and in the standing position, and under compression with the ultrasound probe. Results The small saphenous, but not the deep calf vein cross-sectional area was smaller in controls than in limbs with category C3 or C5 disease while not different from C1s. When changing from the supine to the standing position, a greater force was required to collapse leg veins, of which the cross-sectional area increased in most subjects but decreased in 31.5% of subjects for the small saphenous and 40.5% for the deep calf vein. The small saphenous vein area versus compression force function followed a hysteresis loop, demonstrating viscoelastic features. Its area, which represents the viscosity component, was greater (p Conclusion Postural changes in cross-sectional area of leg veins are highly diverse among patients with chronic venous diseases as well as among healthy subjects, and appear unsuitable for pathophysiological characterization, whereas small saphenous vein viscoelasticity increases consistently in the standing position and viscosity is greater in limbs with C3 and C5 CEAP categories than in controls.