Arterial Flow Enhancement by Impulse Compression

Abstract

Preliminary observations of rapid relief of ischemic rest pain following application of a foot impulse compression device prompted this study to quantify its immediate effects.Blood flow was calculated by means of a duplex ultrasound imager interfaced with a Doppler spectrum analyzer.Twelve normal subjects and 10 patients with peripheral vascular disease (mean Doppler ankle/brachial systolic pressure index = 0.62 (range 0.33-0.74) were studied. Mean resting blood flow ( SD) was not significantly different in the two groups: 55.6 24.0 in normal subjects and 48.3 29.8 in the arteriopaths (p = > 0.1). During five minutes of pump application in a 45-degree foot-down position, mean popliteal blood flow increased by 93% in normal subjects (p < 0.0001) and 84 % in peripheral vascular patients (p < 0.03); there was no change in the opposite limb. In 5 normal subjects a "placebo" device produced no significant change in flow (p >0.

Acute Effects of Intermittent Pneumatic Compression on Popliteal Artery Blood Flow

“…Previous studies have determined that this timing and rate resulted in the maximal venous return in normal volunteers. 20 After a 10-minute baseline period, in which the popliteal artery blood flow was measured 5 times, IPFCC was applied for 10 minutes. During the IPFCC application, popliteal artery blood flow was measured an additional 5 times.…”

“…Using xenon 133 clearance rates, Gaskell and Parrott 24 demonstrated that pneumatic foot and ankle compression increased the blood flow 80% in the limbs of sitting patients with peripheral arterial disease. More recently, Morgan and associates 20 showed that foot compression not only increased venous return but also produced a postcompression arterial hyperemia. Similar results were found in another study in which calf compression was applied.…”

“…26 Delis et al 27 demonstrated that by combining foot and calf compression (with a 1-second delay in calf compression) a significantly lower venous pressure could be produced than with foot or calf compression alone. These studies [20][21][22][23][24] suggested that the increased blood flow was partially due to the reduction of peripheral vascular resistance. Since vascular resistance is dependent on arterioles, vasodilation of these vessels may be responsible for the hyperemia.…”

A Call to Action: Women and Peripheral Artery Disease

“…[282][283][284][285][286][287][288] Women constituted 30% of participants in the studies of lower extremity pneumatic compression as treatment for symptomatic PAD that evaluated clinical outcomes and reported gender. 289 -291 These studies each included Յ50 patients and did not report any gender-specific analyses.…”

Diabetic foot disease and oedema

“…[37][38][39] The A-V Impulse System was developed to mimic the natural physiological processes which maintain blood flow and has been shown to improve venous return and arterial blood flow in the extremities. 40,41 The proposed mechanism of action is that intermittent pneumatic compression leads to improved emptying of the lower extremity veins and lowered venous pressure which in turn results in an increase in arterio-venous pressure gradient and an increase in lower extremity arterial blood flow. [42][43][44] In a cohort study of 40 lower limbs of 30 subjects, the application of intermittent pneumatic compression to calf and foot greatly enhanced popliteal artery blood flow.…”