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INFRA-RED LIGHT REOGRAPHY WITH TELEMETRY IN THE STUDY OF CHRONIC VENOUS INSUFFICIENCY

Author: R. Polignano

Angiology Dpt. Camerata Hospital ASL 10 Florence (Italy) - email:polignan@dada.it

INTRODUCTION.
Chronic Venous insufficiency (CVI) can have different origins. We can observe a superficial insufficiency or a deep reflux or both, associated to the insufficiency of some perforating veins. A defect in the muscular pump or the presence of orthopaedic limb diseases can worsen the problem. In the last few decades many methodical diagnostics have been investigated in order to study the physiopathology of the CVI. Some of them are rather invasive, like the phlebography and the direct measurement of the venous pressures; others like ultrasound techniques and the strain gauge plethismography are not invasive, but more difficult to carry out or requesting long periods of training. Among these only the photoplethismography enables us to estimate the superficial venous plexus at skin level which is the target of microcirculatory defects. This technique, simple and non invasive, which uses infra-red light, shows the time taken for the superficial veins to refill after exercise (Refilling Time). The repetition of the test at different levels after having excluded the venous superficial refluxes with a tourniquet gives information on the effectiveness that a possible surgery will have on that district, but at the same time we can quantify the effectiveness of elastocompression or of a phlebological plantar.

AIM OF THE STUDY
is to verify the effectiveness of a particular photoplethysmographic system that allows us to study the Patient during a real simulation of his daily physical activity. We have therefore used a new system of telemetry (Microlab Electronic Padua Italy) with frequency band 868,00 - 870,0 MHz, type of digital modulation FM with error corrector, output RF5 mW, connected to the infra-red reography. This system allowed us to perform the test letting the patient walk freely within 30m. A receiver connected to the PC recorded the light signal sent via radio from the little transducer on the patient’s leg.

CONCLUSION.
During this test the patient can therefore walk freely, climb the stairs, use a treadmill , walk with or without stockings and with the aid of a phlebological plantar or with adequate footwear. It is also possible to overcome the problems of those old patients unable to flex the ankle, condition that reduces the calf muscular pump. Moreover the follow up of post-thrombotic syndrome is improved, with low costs and good reproducibility. We therefore suggest this method to the vascular rehabilitation centres that are so efficient for the arterial care, but not as much for the venous treatments. The main limit of this test is the presence of significant dyschromia on the leg, but it could be bypassed using a volumetric detector instead of the usual infra-red transducer.