The haemodynamic diagnostic of the venous insufficiency of the lower limbs

has the aim of detecting and defining the pathological points of venous blood outflow.

In the case of severe deterioration of the outflow pathways toward the right side of the heart, due to occlusion of primary pathways or malfunction of the central pumps, further tests will be required in order to assess the increase in peripheral resistances of the posterior tibial veins with the sphygmomanometer and Echo Color Doppler.

However, in most cases, tests are run with the help of Echo Color Doppler to detect reflux where flow moves in the opposite direction due to the absence or malfunction of valves.

In order to do this, some haemodynamic manoeuvres reproducing what happens during the movement of the body should be performed. These include gravitational tests such as the Valsalva manoeuvre, the Cremona manoeuvre, static gravitational tests such as the squeezing, or finally dynamic tests such as Paraná manoeuvre or Swinging.

Once you have detected the reflux, a Shunt with its escape point, escape pathways and re-entry point must be located.

An Echo Color Doppler diagnostic process involves the following main steps: examination of the popliteal fossae, examination of the common femoral vein, examination of the superficial femoral vein, examination of the deep femoral vein, examination of the tibial vein, of the saphenous-femoral joint, and study of the state of the inner saphenous trunk.

The diagnosis is shown on a cartographic map, a unique instrument that enables us to make a decision regarding whether or not conservative mini-invasive CHIVA therapy should be used. 

Venous haemodynamic Echo Color Doppler study

The Haemodynamic approach to arteoriopathies

 In this video, the variation of the flow velocity in a normal radial artery at the variation of the hydrostatic pressure, in the case of an increase and decrease of the peripheral resistances, can be seen. It is visible evidence of the general flow law that involves the pump, the compliance of the vessel and resistance to understand the flow variations.