Compression‐induced pulsatile blood flow changes in human legs

Abstract

Initial and sustained (7-h) impacts of foot-to-knee compression bandaging on leg arterial pulsatile blood flow were assessed by nuclear magnetic resonance flowmetry in eight healthy supine subjects. A widely used bandaging method (zinc impregnated gauze + Coban) and a slight variant (Coban only) were applied one week apart to one leg. Blood flow was measured on each day of bandage application before and after bandaging and after 7 h of normal activity. Initial mean sub-bandage pressures (lateral gaiter) were between 28.4 and 28.9 mmHg but were significantly reduced after 7 h to 16.3-19.4 mmHg. Overall below-knee pulsatile blood perfusion was initially significantly increased by both methods mainly due to increased proximal blood flow. Bandaging was also associated with a decrease in blood perfusion of the nonbandaged control leg mainly due to a decrease in distal blood flow. Neither of these effects were sustained after 7 h. The fact that neither sub-bandage pressure nor blood flow was sustained may indicate a causal linkage, a concept consistent with the finding of a linear relationship between afternoon blood flow and sub-bandage pressure reductions. The implications of the present findings for venous ulcer therapy are speculative and based on the concept that arterial pulsatile flow augmentation is a positive feature. If so, more frequent bandage changes to provide transient flow stimulation or use of bandages to better maintain sub-bandage pressure to sustain flow increases may be useful.

External compression increases forearm perfusion

“…A few previous studies addressed the effects of moderate leg compression on arterial inflow (18,22,23,25). In one of these studies, application of graded compression pressure did not change calf muscle blood flow (18); in this study, muscle blood flow was determined by measuring xenon-133 clearance, and the maximally applied compression pressure was 30 mmHg.…”

“…However, application of external pressure could also affect arterial vessel tone regulation directly. An effect on arterial flow is indicated by a study on volunteers in whom, during foot-to-knee compression bandaging, an increase of lower leg pulsatile blood flow was observed by nuclear magnetic resonance (MR) flowmetry (22,23). Intermittent pneumatic foot and calf compression is also an effective therapeutic means to reduce the symptoms of venous insufficiency (4,17,19,26).…”

“…Using color flow duplex imaging of the popliteal artery, Labropoulos et al (17) found increased blood flow in healthy volunteers during intermittent pneumatic foot and calf compression. Two studies (17,22) indicate that compression influences venous outflow as well as arterial inflow. However, the relation between the compressive pressure and the change in blood flow remains unclear.…”

Compression therapy in mixed ulcers increases venous output and arterial perfusion

“…In two studies of healthy participants, Mayrovitz et al 31,37,38 were able to demonstrate an increase of arterial perfusion under stiff bandages exerting a mean pressure in the supine position of 28 and of 40 mm Hg, respectively. LDF in the great toe revealed a moderate reduction in the flux values with increasing sub-bandage pressures being significant in the pressure range of 41 to 50 mm Hg.…”

Hybrid diffuse optical techniques for continuous hemodynamic measurement in gastrocnemius during plantar flexion exercise

“…The probe was carefully attached so as to remain in contact with the skin without applying excessive pressure, a condition that may cause hemodynamic variations. [42][43][44] The optical fibers connected to the probe were then taped to the measurement chair to reduce the effect of their weight on the probe/tissue interface. A strain gauge with loop lengths of 26 to 32 cm (Hokanson E8, Massachusetts) was placed at the proximal end of the optical probe just above the site of greatest circumference.…”