Noninvasive diagnosis and quantitation of popliteal reflux in the swollen and ulcerated leg.

Air-plethysmography was used to study 25 normal legs (N), 25 legs with primary varicose veins (PVV) without sequelae of venous disease (chronic swelling, skin changes, ulceration), 32 legs with primary varicose veins with sequelae of venous disease (PVV/S) and 32 legs with reflux in the popliteal vein (PR). The blood volume that filled the leg veins on standing from recumbent position (venous volume [VV]) in ml and the time needed for 90% filling of the veins (venous filling time [VFT90]), in seconds were measured. The ratio 90% of VV/VFT90 was defined as venous filling index (VFI) in ml/sec. VFI is a measurement of reflux. The measurements were repeated with a 2.5 cm wide tourniquet (T) placed at the knee level to occlude the superficial veins only. The method, apart from its diagnostic accuracy, can measure reflux separately in the superficial and the deep venous system and has indicated that the magnitude of reflux is related to chronic swelling and ulceration of the leg, irrespective of whether it is in the superficial or deep system.