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Acta Phlebologica 2017 December;18(3):102-9

DOI: 10.23736/S1593-232X.17.00393-9


lingua: Inglese

Hemodynamics of the sapheno-femoral junction: mathematical modeling and clinical implications in chronic venous disease

Vincenzo COSCIA 1, 2, Vincenzo GASBARRO 1, 3, Luca TRAINA 3, Stefano DE FRANCISCIS 1, 2, 3, 4, Raffaele SERRA 1, 2, 3, 4

1 Interuniversity Center of Phlebo-Lymphology (CIFL), International Research and Educational Program in Clinical and Experimental Biotechnology, Magna Græcia University, Catanzaro, Italy; 2 Department of Mathematics and Computer Science, University of Ferrara, Ferrara, Italy; 3 Department of Morphology, Surgery, and Experimental Medicine, University of Ferrara, Ferrara, Italy; 4 Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy

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BACKGROUND: The incompetence of the sapheno-femoral junction (SFJ) represents a major point in the actual discussion on the venous hemodynamics of lower limbs in chronic venous disease (CVD).
METHODS: From 2014 June to 2017 June in the laboratory of non-invasive vascular diagnostics of the Operative Vascular Surgery Unit of the University Hospital of Ferrara we recruited 122 patients (sex: 37 males, 85 females; age range: 22-72 years; median age: 51 years). All patients were subjected to morphologic and geometric evaluations; vessels diameters, speed and direction of hematic flow were evaluated by Doppler echocardiography (DECG) technique. We performed a mathematical modeling among different hemodynamic evaluations through the use of DECG in order to evaluate local fluid dynamical parameters.
RESULTS: The analysis of numerical results allowed the identification of three different hemodynamic situations that are particularly critical for the SFJ circulation.
CONCLUSIONS: The present experience represents an evidence based medicine study that in the next future could be useful for clinical decision-making process in CVD in order to simplify the choice of the therapeutic options, specific for each patient and based on objective, controllable and reproducible parameters.

KEY WORDS: Venous insufficiency - Hemodynamics - Femoral artery - Saphenous vein - Decision support techniques

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