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. 1983 Apr;197(4):450–453. doi: 10.1097/00000658-198304000-00013

Intramuscular pressure in the lower leg in deep vein thrombosis and phlegmasia cerulae dolens.

P Qvarfordt, B Eklöf, P Ohlin
PMCID: PMC1352760  PMID: 6830350

Abstract

The influence of deep vein thrombosis on intramuscular pressure was evaluated in 22 patients by means of the wick technique. Intramuscular pressure was measured in the anterior tibial and the deep posterior compartments in both legs before and during treatment. The intramuscular pressure was significantly (p less than 0.001) higher in the thrombosed leg than in the contralateral leg (0-16 mmHg). The increase in intramuscular pressure was related to the extension of the thrombus. Iliofemoral thrombosis caused a significantly (p less than 0.001) higher pressure (17-28 mmHg) than calf thrombosis (16-23 mmHg). A compartment syndrome was found to be a part of the entity phlegmasia cerulea dolens (rest pressure 47-56 mmHg). In the treatment of phlegmasia cerulea dolens, fasciotomy is suggested additional to other therapeutic procedures.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ANLYAN W. G., HART D. Special problems in venous thromboembolism. Ann Surg. 1957 Sep;146(3):499–509. doi: 10.1097/00000658-195709000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. BROCKMAN S. K., VASKO J. S. OBSERVATIONS ON THE PATHOPHYSIOLOGY AND TREATMENT OF PHLEGMASIA CERULEA DOLENS WITH SPECIAL REFERENCE TO THROMBECTOMY. Am J Surg. 1965 Apr;109:485–492. doi: 10.1016/s0002-9610(65)80182-9. [DOI] [PubMed] [Google Scholar]
  3. BURTON A. C. On the physical equilibrium of small blood vessels. Am J Physiol. 1951 Feb;164(2):319–329. doi: 10.1152/ajplegacy.1951.164.2.319. [DOI] [PubMed] [Google Scholar]
  4. Brockman S. K., Vasko J. S. Phlegmasia cerulea dolens. Surg Gynecol Obstet. 1965 Dec;121(6):1347–1356. [PubMed] [Google Scholar]
  5. Brockman S. K., Vasko J. S. The pathologic physiology of phlegmasia cerulea dolens. Surgery. 1966 Jun;59(6):997–1007. [PubMed] [Google Scholar]
  6. Bülow S., Sager P. Venous gangrene. Acta Chir Scand. 1975;141(4):272–278. [PubMed] [Google Scholar]
  7. ELLIS J. T., WINDHAM S. W. Acute massive venous occlusion in the lower extremity. Ann Surg. 1952 Feb;135(2):262–266. doi: 10.1097/00000658-195202000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. FOGARTY T. J., CRANLEY J. J., KRAUSE R. J., STRASSER E. S., HAFNER C. D. Surgical management of phlegmasia cerulea dolens. Arch Surg. 1963 Feb;86:256–263. doi: 10.1001/archsurg.1963.01310080080019. [DOI] [PubMed] [Google Scholar]
  9. FONTAINE R., TUCHMANN L. THE ROLE OF THROMBECTOMY IN DEEP VENOUS THROMBOSES. INDICATIONS AND RESULTS. J Cardiovasc Surg (Torino) 1964 Jul-Aug;5:298–312. [PubMed] [Google Scholar]
  10. GULLMO A. On the technique of phlebography of the lower limb. Acta radiol. 1956 Oct;46(4):603–620. doi: 10.3109/00016925609171453. [DOI] [PubMed] [Google Scholar]
  11. Galvin C. Phlegmasia cerulea dolens. Angiology. 1971 May;22(5):237–243. doi: 10.1177/000331977102200501. [DOI] [PubMed] [Google Scholar]
  12. HALLER J. A., Jr, ABRAMS B. L. USE OF THROMBECTOMY IN THE TREATMENT OF ACUTE ILIOFEMORAL VENOUS THROMBOSIS IN FORTY-FIVE PATIENTS. Ann Surg. 1963 Oct;158:561–569. doi: 10.1097/00000658-196310000-00006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Hargens A. R., Mubarak S. J., Owen C. A., Garetto L. P., Akeson W. H. Interstitial fluid pressure in muscle and compartment syndromes in man. Microvasc Res. 1977 Jul;14(1):1–10. doi: 10.1016/0026-2862(77)90136-4. [DOI] [PubMed] [Google Scholar]
  14. Mubarak S. J., Hargens A. R., Owen C. A., Garetto L. P., Akeson W. H. The wick catheter technique for measurement of intramuscular pressure. A new research and clinical tool. J Bone Joint Surg Am. 1976 Oct;58(7):1016–1020. [PubMed] [Google Scholar]
  15. Patman R. D. Compartmental syndromes in peripheral vascular surgery. Clin Orthop Relat Res. 1975 Nov-Dec;(113):103–110. doi: 10.1097/00003086-197511000-00015. [DOI] [PubMed] [Google Scholar]
  16. Qvarfordt P., Eklöf B., Ohlin P. Reference values for intramuscular pressure in the lower leg in man. Clin Physiol. 1982 Oct;2(5):427–434. doi: 10.1111/j.1475-097x.1982.tb00049.x. [DOI] [PubMed] [Google Scholar]
  17. STALLWORTH J. M., BRADHAM G. B., KLETKE R. R., PRICE R. G., Jr PHLEGMASIA CERULEA DOLENS: A 10-YEAR REVIEW. Ann Surg. 1965 May;161:802–811. doi: 10.1097/00000658-196505000-00018. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Tagariello P. Pathogenesis of venous gangrene. J Cardiovasc Surg (Torino) 1966 Nov-Dec;7(6):504–510. [PubMed] [Google Scholar]
  19. VEAL J. R., DUGAN T. J., JAMISON W. L., BAUERSFELD R. S. Acute massive venous occlusion of the lower extremities. Surgery. 1951 Mar;29(3):355–364. [PubMed] [Google Scholar]
  20. Wright C. B., Swan K. G. Hemodynamics of venous occlusion in the canine hindlimb. Surgery. 1973 Jan;73(1):141–146. [PubMed] [Google Scholar]

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