Laser-Doppler examination of corona phlebectatica paraplantaris

Abstract

Aim: Corona phlebectatica paraplantaris (CPP) is a typical sign of chronic venous insufficiency (CVI). The aim of our study was to obtain information about the basic microcirculation and microvascular reactivity in CPP.

Methods: Microcirculation of the skin was investigated on the surface of CPPs and as a control in a nearby vessel-free skin region of the foot. The resting flow was recorded in a supine position, then different provocation tests were performed such as local heating (44 ˚C, 2 min), postocclusive reactive hyperemia (PORH, 220 mmHg, 3 min) and venoarterial response (VAR).

Results: There were significant differences between the circulation of CPPs and control skin: resting flux and amplitude values were higher in CPPs. Spectral analysis showed higher endothelial, sympathetic, myogenic, breathing and heart activities in CPPs. At the beginning of the PORH test, compression of the leg increased the flow in CPPs. Other PORH parameters, the response to local heating and VAR were not different in the two areas studied.

Conclusion: High resting flux values and large amplitudes in CPPs suggest more the presence of open AV shunts in the ankle region than the role of calibre differences. Pathological responses to different provocation tests can be a consequence of the CVI.