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Venous compliance and clinical implications

Paolo Zamboni, Valentina Tavoni, Francesco Sisini, Massimo Pedriali, Erika Rimondi, Mirko Tessari, Erica Menegatti
  • Paolo Zamboni http://orcid.org/0000-0002-7107-888X
    The Department of Morphology, Surgery and Experimental Medicine and Vascular Diseases Center, University of Ferrara; Unit of Translational Surgery and Vascular Diseases Centre, Azienda Ospedaliera Universitaria, Ferrara, Italy | paolozamboni@icloud.com
  • Valentina Tavoni
    Section of Medical Physics, Department of Physics and Earth Sciences, University of Ferrara, Italy
  • Francesco Sisini
    Section of Medical Physics, Department of Physics and Earth Sciences, University of Ferrara, Italy
  • Massimo Pedriali
    Morbid Anatomy Service, Azienda Ospedaliera Universitaria, Ferrara, Italy
  • Erika Rimondi
    Department of Morphology, Surgery and Experimental Medicine and LTTA Centre, University of Ferrara,
  • Mirko Tessari
    The Department of Morphology, Surgery and Experimental Medicine and Vascular Diseases Center, University of Ferrara; Unit of Translational Surgery and Vascular Diseases Centre, Azienda Ospedaliera Universitaria, Ferrara, Italy
  • Erica Menegatti
    The Department of Morphology, Surgery and Experimental Medicine and Vascular Diseases Center, University of Ferrara; Unit of Translational Surgery and Vascular Diseases Centre, Azienda Ospedaliera Universitaria, Ferrara, Italy

Abstract

Compliance is a characteristic of every deformable system. Compliance is very clear concept in physics and mechanics but in clinics, perhaps, is not the same. However, in veins compliance fits perfectly with the function of drainage of the venous system. Volumetric increase (dV) of the content is correlated with pressure increase (dP) inside the vein according to the equation C’= dV/dP. In humans 75% of the blood is located in the venous system, primarily because the molecular components of a vein media layer is significantly more compliant to that of arteries. This property is fundamental to understanding the change in blood volume in response to a change in posture. Measurements of venous compliance in clinical practice can be done by the means of ultrasound, as well as with the plethysmography. Ultrasound methods assimilate the cross sectional area to the volume of the vein, because it reflects the blood content. Changes in cross sectional area can be reliably measured in response to a change in posture, while pressure can be derived from the hydrostatic pressure changes. Venous compliance is of paramount importance also in pulsatile veins such as the inferior or superior vena cava and the jugular veins, where high resolution ultrasound may accurately derive the cross sectional area. Clinical implications of the mechanical properties of the venous wall are extensively discussed, including the need of dedicated venous stenting, which takes into account venous compliance as the main parameter of the venous function. In addition, venous compliance is the interpretative key for a better understanding of plethysmography curves, as well as of varicose veins and of their return to normal cross sectional area following ambulatory venous pressure reduction.

Keywords

Veins; mechanical wall properties.

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Submitted: 2018-02-21 11:49:24
Published: 2018-05-14 16:19:33
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Copyright (c) 2018 Paolo Zamboni, Valentina Tavoni, Francesco Sisini, Massimo Pedriali, Erika Rimondi, Mirko Tessari, Erica Menegatti

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