Neurovascular Bundles in the Lower Extremities: Can Arterial Pulse Pressure Help Venous Return?

A 2022 study tested artery-vein bundles and asked whether an arterial pulse can help nearby veins move blood back toward the heart.

The researchers used settings similar to a healthy adult:

Arterial pulse pressure: ~50 mmHg
Pulse rate tested: 60-150 beats/min
Vein segment length: 10-15 cm
Venous pressure gradient tested: 0-40 mmHg

What did they find?

When venous pressure was very low, there was no measurable flow through the vertical vein segment.

When the venous pressure gradient reached about 25 mmHg, the artery pulse started to help, and the increase in venous flow became highly significant. The strongest helpful range was around 25-35 mmHg.

When pulse rate doubled from 70 to 140 beats/min, venous flow increased in the same direction.

But when the venous pressure gradient reached 40 mmHg, the effect reversed: arterial pulsation had a negative effect on venous flow.

Simple takeaway: In lower-extremity neurovascular bundles, an arterial pulse may act like a small companion pump next to the vein–but only when the venous pressure gradient and valve position are right. It helps most around 25–35 mmHg, not at very low pressure or around 40 mmHg.

Reference

LeFevre NM, Sarvazyan N. The essential role of arterial pulse in venous return. Am J Physiol Regul Integr Comp Physiol. 2022 Dec 1;323(6):R962-R967.