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  • Title: High compression pressure over the calf is more effective than graduated compression in enhancing venous pump function.
    Author: Mosti G, Partsch H.
    Journal: Eur J Vasc Endovasc Surg; 2012 Sep; 44(3):332-6. PubMed ID: 22819741.
    Abstract:
    BACKGROUND: Graduated compression is routinely employed as standard therapy for chronic venous insufficiency. AIM: The study aims to compare the haemodynamic efficiency of a multi-component graduated compression bandage (GCB) versus a negative graduated compression bandage (NGCB) applied with higher pressure over the calf. METHODS: In 20 patients, all affected by greater saphenous vein (GSV) incompetence and candidates for surgery (Clinical, etiologic, anatomic and pathophysiologic data, CEAP C2-C5), the ejection fraction of the venous calf pump was measured using a plethysmographic method during a standardised walking test without compression, with GCB and NGCB, all composed of the same short-stretch material. Sub-bandage pressures were measured simultaneously over the distal leg and over the calf. RESULTS: NGCBs with median pressures higher at the calf (62 mmHg) than at the distal leg (50 mmHg) achieved a significantly higher increase of ejection fraction (median +157%) compared with GCB, (+115%) with a distal pressure of 54 mmHg and a calf pressure of 28 mmHg (P < 0.001). CONCLUSIONS: Patients with severe venous incompetence have a greater haemodynamic benefit from NGCB, especially during standing and walking, than from GCB.
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