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A Journal on Phlebology
Acta Phlebologica 2013 April;14(1):15-7
Motive forces of the venous circulation in the lower extremity
Retired, formerly Department of Surgery, University Hospital, Hradec Kralove, Czech Republic
Calf pump activity produces the force propelling venous blood in the lower extremity against the gravitation to the heart; competent vein valves impede retrograde flow. Pressure gradient develops between the veins in the thigh and the lower leg during calf pump activity. In varicose vein disease, the pressure gradient sets off both the venous reflux and the process leading to varicose vein recurrence after abolition of saphenous reflux. Venous reflux, i.e. centrifugal streaming within an incompetent venous conduit connecting both pole of the pressure gradient is the main pathological factor in varicose vein disease: it causes ambulatory venous hypertension. After abolition of reflux in the groin, the pressure gradient is transmitted into the thigh between the femoral vein and the remnant of the great saphenous vein and triggers formation of new venous communications between both venous systems, which ultimately results in recurrent reflux.