What is the role of the venous refilling time measurement in the diagnosis of varicose veins and spider veins (telangiectasia)?

Updated: Feb 28, 2018
  • Author: Robert Weiss, MD; Chief Editor: William D James, MD  more...
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Answer

The venous refilling time is the time necessary for the lower leg to become suffused with blood after the calf muscle pump has emptied the lower leg as thoroughly as possible.

When perfectly healthy patients are in a sitting position, venous refilling of the lower leg occurs only through arterial inflow and requires at least 2 minutes.

In patients with mild and asymptomatic venous insufficiency, some venous refilling occurs by means of reflux across leaky valves. These asymptomatic patients have a VRT that is 40-120 seconds.

In patients with significant venous insufficiency, venous refilling occurs through high-volume reflux and is fairly rapid. These patients have an abnormally fast VRT of 20-40 seconds, reflecting retrograde venous flow through failed valves in superficial and/or perforating veins. This degree of reflux may or may not be associated with the typical symptoms of venous insufficiency. Such patients often report nocturnal leg cramps, restless legs, leg soreness, burning leg pain, and premature leg fatigue.

A venous refilling time of less than 20 seconds is markedly abnormal and is due to high volumes of retrograde venous flow. High-volume reflux may occur via the superficial veins, the large perforators, or the deep veins. This degree of reflux is nearly always symptomatic. If the refilling time is shorter than 10 seconds, venous ulcerations are so common as to be considered virtually inevitable.


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