Key result
Symmetric cuff compression matches asymmetric for posterior tibial vein reduction but better compresses anterior veins.
Why the study?
A validated model of calf compression and deep vessel collapse during external cuff inflation is needed to understand venous haemodynamics and improve cuff design.
Does symmetric versus asymmetric external cuff compression affect deep vessel collapse in normal volunteers?
Does symmetric versus asymmetric external cuff compression affect deep vessel collapse in normal volunteers?
Absolute Event Rate: 89% vs 81%
Symmetric compression achieves greater compression of anterior tibial veins compared to asymmetric compression, and external measurements of calf tissue deformation do not accurately predict deep vessel collapse.
External calf deformation poorly predicts deep vein collapse; leaves open optimal cuff design for venous interventions.
This paper presents a validated model of calf compression with an external pressure cuff as used for deep vein thrombosis. Magnetic resonance (MR) images of calf geometry were used to generate subject-specific finite-element (FE) models of the calf cross section. Ultrasound images of deep vessel collapse obtained through a water-filled cuff were used to validate model behavior. Calf/cuff pressure interface measurements were applied to the FE model and the resulting tissue deformation was compared with MR image in normal volunteers (three females, four males, age range 20-55) using two distinct cuffs. MR observations and the model results showed good qualitative agreement. A similar reduction in cross-sectional area of the posterior tibial veins was obtained under both symmetric compression (89%) and asymmetric compression (81%), but greater compression of the anterior tibial veins was achieved with symmetric compression. The need to account for the effective compressibility of the calf tissue suggests that external measurements of the calf tissue deformation will not accurately predict deep vessel collapse. These results have implications for the modification of venous haemodynamics by such systems and could help to improve cuff design.
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Narracott et al. (2008) studied Healthy volunteers (n=7). Symmetric compression vs. Asymmetric compression was evaluated on Reduction in cross-sectional area of the posterior tibial veins. Symmetric and asymmetric external cuff compression achieved similar reductions in posterior tibial vein cross-sectional area (89% vs 81%), but symmetric compression better compressed anterior veins.
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