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“Rapid” compression technique to treat PAD

Rapid Compression:  How Fast is Fast Enough?

Compression pump systems for peripheral arterial disease treatment and wound care are becoming more and more popular these days. As more people seek treatment for conditions caused by poor circulation, the number of cases contraindicated for surgical intervention also rises. So, to find an alternative to amputation, some medical device makers are advertising their pumps as a solution.

In general, here’s what you’ll see:

  • Cuffs/sleeves:  can cover the foot & calf or just the calf
  • Pressure:  90 – 120 mmHg

Here’s a secret, though:  most of these “arterial pumps” are nothing but DVT prophylaxes or lymphedema pumps that are modified to exert more pressure. Minor adjustments such as these have been largely untested in a clinical setting and therefore yield fairly unpredictable results.

ACI Medical is the only device maker to have uncovered the most important aspect of compression therapy as a means of treating PAD:  rapid compression (under 0.5 seconds) that serves as a close physiological substitute for brisk walking.

ArtAssist device compression sequence

Unlike all other compression pumps, ACI Medical’s ArtAssist® Arterial Assist Device® was engineered on the premise of understanding the underlying physiology of increasing arterial blood flow and focusing on results that will benefit patients with critical limb ischemia. Since developers and researchers understood how important exercise was for patients with arterial disease, they engineered a device that would bring the important physiological benefits of walking to patients with limited mobility.

Early physiological studies led by Dr. Paul van Bemmelen, Professor Andrew Nicolaides, and others showed a great understanding of the vascular system of the legs. When we exercise, our calf muscles push blood rapidly through the veins to the heart where it can be recycled and directed back towards the leg muscles with essential nutrients. Therefore, in patients who have difficulty walking, it was essential to emulate the calf muscle’s role in pumping blood without having the patient do exercise.

So, when a patient uses the ArtAssist® device, it is as if the device system is “walking” for them. Patients do not experience pain and, over a period of about three months, benefits become long-term.

The real experts on Arterial Pump Technology are only a click or call away. Email info@acimedical.com or call toll free (888) 4 LEG FLO

Relevant clinical trials using the ArtAssist® device:

Rapid Intermittent Compression Increases Skin Circulation in Chronically Ischemic Legs with Infra-popliteal Arterial Obstruction.
van Bemmelen, P.S.; Weiss-Olmanni, J. and Ricotta, J.J. Div. of Vascular Surgery, State University of New York, Stony Brook.
VASA 2000;29:47-52

The Contributions of Arterial and Venous Volumes to Increased Cutaneous Blood Flow During Leg Compression. Eze, A.R.; Cisek, P.L.; Holland, B.S.; Comerota, A.J. Jr.; Veeramasuneni, R.; and Comerota, A.J. Philadephia, Pennsylvania, Charlotte and Gastonia, North Carolina. Annals of Vascular Surgery, 1998;12:182-186

Effects of Intermittent Pneumatic Compression of the Calf and Thigh on Arterial Calf Inflow: A Study of Normals, Claudicants, and Grafted Arteriopaths. Delis, K.T.; Husmann, J.W.; Cheshire, N.J.; and Nicolaides, A.N. Imperial College School of Medicine, St. Mary’s Hospital, London, UK. Surgery, 2000, Vol. 129, No. 2, p. 188-195

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A modified DVT pump for treating arterial disease? Don’t waste your time.

These days, intermittent pneumatic compression therapy is being used to treat edema, prevent deep vein thrombosis, and, more recently, similar devices have emerged claiming to treat peripheral arterial disease, a serious result of poor circulation in the limbs.

Some device manufacturers will tell you, “Hey, this pump that we use to prevent DVT and reduce edema can ALSO be used to treat arterial disease if you just kick the pressure up a notch.” Or at least they think so. It’s still a compression pump, right? And this DVT/edema/arterial pump will kill two birds with one stone, right? So why not?

unequal

The biomedical engineers here at ACI Medical and the vascular surgeons they work with can set this straight:  the simple answer is that, since arterial disease and venous disease are inherently different, they should be treated differently.

The companies that just modify lymphedema and DVT pumps and claim these systems can prevent amputations caused by peripheral arterial disease do so without much evidence to back them up. Do their pumps work? Maybe. Is that good enough? Come on.

The team that developed ArtAssist®…the Arterial Assist Device® for ACI Medical approached the arterial pump concept very differently. They realized early on that the new concept of treating peripheral arterial occlusive disease with non-invasive arterial pump compression therapy deserved a lot more thought. With that, they started from scratch and set these goals:

Understand the underlying physiology of increasing arterial blood flowThe ArtAssist Arterial Pump Device

Design a device based on this understanding

Determine the long-term clinical benefit(s) to patients with critical limb ischemia

Starting in the early 1990’s, ACI Medical’s team of biomedical engineers and vascular surgeons began a thorough progression of research and clinical trials that started with incorporating their most promising findings into the design and function of the ArtAssist® device.

Today, doctors from all around the country (and even some in other countries) prescribe this optimized arterial pump to their non-operable PAD patients because they know how critical it is for threatened limbs to receive optimized therapy that’s been proven to work again and again.

So it’s time for me to put up or shut up – view study abstracts on the ArtAssist® device at this link:

http://acimedical.com/artassist/clinical-studies/

My suggestion:  start with the History and Literature Review and our Scientific Brochure.

Then, call ACI Medical at our toll free number (888) 453-4356 or email Don, our Director of Sales & Marketing, at info@acimedical.com to talk to a real, live expert.

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Dr. Paul van Bemmelen talks about treating PAD without surgery on eHealth Radio

Just in time for PAD Awareness Month is an interview by the very kindly Eric Michaels on the eHealth Radio podcast, “ArtAssist Paul van Bemmelen, MDtreatment helps poor circulation with Dr. Paul van Bemmelen“.

For being only 7 minutes long, this interview covers a lot of ground with the ArtAssist® device in a way that only Dr. van Bemmelen, as a key developer, can articulate. Listeners from all walks of life can learn a little bit from him as he exposes the harsh (yet unfortunately common) realities that patients with non-surgical PAD endure and more importantly, what your doctor can do to help you.

Excerpt:

Now, you have developed a device with ACI Medical to assist the arteries with the circulation called the ArtAssist®. What is it and how does that work?

Humans are unique because we are upright, and as long as we keep moving, our leg muscles are squeezing the blood back toThe ArtAssist Arterial Pump Device the heart and assist in the circulation work. But modern humans are typically not active enough. The ArtAssist® is essentially a strong massage device that people can use at home. It obtains the good effects of walking – that is, increased blood flow – without the bad effects of walking, such as the need for more oxygen in the leg muscles with more pain. Also, real walking can worsen the friction between the skin and the shoes, which causes problems in diabetes.

So go ahead and tune in! You definitely won’t be sorry you did.

Visit the eHealth Radio website to gain access to this interview and many more health-related topics, or click here to open the media player.

Also be sure to check out Dr. van Bemmelen’s most recent article for faim.org, “Walking therapy and pneumatic compression:  the natural cures for poor leg circulation”
Thanks! I hope you enjoy listening!
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“Walking Therapy and Pneumatic Compression: The Natural Cures for Poor Leg Circulation” | Paul van Bemmelen, MD, PhD, FACS

paul van bemmelen md phdYou’ve already seen Dr. Steven Kavros’ article on pneumatic compression device therapy published on faim.org (the Foundation for Alternative and Integrative Medicine).

But just released is yet another article on pneumatic compression therapy with an emphasis on its natural approach to healing non-reconstructable PAD (peripheral arterial disease) patients. This time, FAIM.org is featuring Dr. Paul van Bemmelen, one of the very few vascular surgeons who have conducted the most advanced investigations into the capabilities of arterial pump technology for non-surgical patients with poor leg circulation.

Here is an excerpt from Dr. van Bemmelen’s latest article:

“Because healthcare providers are paid much more for invasive procedures, our healthcare system currently favors costly procedures as the primary solution for circulation problems. In Ireland, a study on 171 patients treated with the compression device, found a savings of about 1.5 million Euros compared to cost of amputation for a matched group of patients.”

In addition, this article gives insight into the origins of compression therapy and why previous attempts at treating PAD with with it had been largely unsuccessful prior to the development of the ArtAssist® device, technology to which Dr. van Bemmelen himself contributed a significant amount of his vascular expertise.

ArtAssist® Arterial Pump Technology is the pioneer for non-invasive intermittent pneumatic compression therapy. By mimicking the benefits of the most natural way of fighting arterial disease, this treatment is proven to provide long-term relief for patients suffering from poor circulation.

Look for the full article on faim.org!

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A PAD Patient with Less Pain | Margie C. on the ArtAssist® Device

Margie tells us that when she had first received the ArtAssist® device from us at ACI Medical, her problems were pretty common for a patient with severe PAD (peripheral arterial disease):

Leg pain when walking, leg cramps mostly at night, toe nails coming off + not growing back normally, swelling in feet and legs from poor circulation.

These days, her testimonial tells us that since Margie has started to use the ArtAssist® device, we are glad to hear that she has gone from having rest pain and imminent tissue loss to being a claudicator.

I still have some pain when walking, the leg cramps seldom, toes are better, and bad swelling only when I overdo. I believe the [ArtAssist®] machine has kept me from worse and I will continue to use it.

Though her symptoms have not completely dissipated, we at ACI are relieved to have provided her with the means to get her out of the danger zone. Her advice to other PAD sufferers:

I would advise anyone with PAD to give it a try.

Thank you for your story, Margie! We are, of course, here for you as your ArtAssist® device therapy continues and we wish you all the best.

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September is National PAD Awareness Month

PAD stands for peripheral arterial disease. According to the US Department of Health & Human Services, PAD affects 8 to 12 million Americans. The severity of this disease’s symptoms can range from intermittent claudication (trouble walking long distances due to discomfort in the calf, thigh or hip) to gangrene and tissue death due to the utter lack of circulation in the foot.

All of us medically-conscious folks know how heart attacks are caused – if we eat too many hamburgers, spend a few too many hours lounging around, have picked up the habit of smoking, or are just genetically unfortunate, our arteries begin to harden (atherosclerosis) and plaque builds up over time, blocking important circulation from getting to the heart.

The same thing happens in our legs for the same reasons! Our PAD Category refers to a wealth of online articles about this disease that affects not only Americans, but millions of people around the world. One that I found highly informative, especially if you’re just learning about PAD, is this one published in The Times of India.

Working for a company whose medical devices come to the aid of patients suffering from severe PAD has given me both knowledge and hope for those who have run out of reliable treatment options.

For National PAD Awareness, I encourage you to educate yourself on what causes PAD, what treatments are typically prescribed, and where to look when even surgical intervention is not possible.

Since 1998, ArtAssist®…the Arterial Assist Device has helped many patients avoid PAD-related amputation. Read about what a few of them have to say.

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Using a Pneumatic Compression Device for Lower and Upper Extremity Peripheral Arterial Disease | FAIM.org

ArtAssist pneumatic compression device

ArtAssist®…The Arterial Assist Device®

by Steven Kavros, DPM

Intermittent pneumatic compression (IPC) of the lower limb is a well-documented method of arterial leg inflow enhancement in patients with peripheral arterial disease (PAD). The mechanism of action parallels the natural muscular contraction of the leg stimulating blood flow. There are three very short compression cycle per minute inflating a cuff encompassing the legs and or feet simulating the beneficial effects of walking. The rapid rise of the cuff pressure assists with emptying of the venous blood of the extremities and allows oxygenated blood to move down the limb delivering nutrients to deprived tissues. This simple mechanism of action also allows edema or swelling of the extremity to be relieved. By relieving swelling, additional oxygenated blood can be delivered to the ischemic limb. Additionally, there is an increase release of nitric oxide and certain tissue and platelet derived growth factors. The nitric oxide has a positive effect on the internal cells that line the vessel wall, enabling relaxation and improved flow. Other tissue and growth factors lead to the development of new blood vessels and therefore, improve the delivery of additional oxygen and nutrients to the extremity.

Read the rest via Using a Pneumatic Compression Device for Lower and Upper Extremity Peripheral Arterial Disease | Foundation for Alternative and Integrative Medicine.

Since the Internet is all about getting info quickly and moving on, here’s what this medical jargon means in plain English…

Dr. Kavros is talking about a leg pump (what we’ll refer to as an arterial pump) that is proven to improve circulation to the legs and feet when the arteries are blocked. When your arteries are significantly blocked, your muscles start sending pain signals to your brain. This is called PAD –  think of it as a heart attack of the legs.

The way this arterial pump technology works is by simulating walking for your blood-deprived muscles. Instead of making you get up and walk, this therapy happens while you’re sitting in a chair. When you walk, blood in the veins travels up to your heart, gets refreshed and loaded with oxygen/nutrients, and then comes back down to feed the starving muscles. The better circulation you have in your legs, the less they will hurt.

Dr. Kavros says that this compression sequence can also reduce swelling. This pump compresses your leg three times per minute. If you use the pump for three hours a day, imagine how much more blood flow you’re getting!

A fringe benefit to this therapy that was recently discovered is your body’s natural release of nitric oxide. This substance is not to be confused with nitrous oxide, which is what your dentist will give you to make you laugh at his dumb jokes while he’s working on your teeth. When nitric oxide is released by the lining of your arteries, your blood vessels temporarily open up to accept more nutritious blood. Again, this happens three times a minute so that your blood vessels are constantly widened throughout therapy.

This is the compression technology Dr. Kavros is talking about:  The ArtAssist® device. To learn more, click the picture!

Update:  Dr. Paul van Bemmelen has also written an article for faim.org about pneumatic compression device therapy for PAD. Read it here

ArtAssist pneumatic compression device

ArtAssist®…The Arterial Assist Device®

 

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Don’t wait around for insurance to save your leg! – Mark H. in Brattle Boro, VT

Mark has been using the ArtAssist® device for almost 15 years! We are also glad to report that his device has saved his left leg from amputation not once, but twice.

Here is Mark’s letter to us:

“Out of many therapies I tried to heal my ulcer, the ArtAssist device was clearly the most effective. Other treatments generally require a certain amount of circulation to the ulcer, while the ArtAssist device addresses the underlying problem by restoring the blood flow necessary for healing.
I quickly started renting the ArtAssist device and then worried about insurance. If I had waited for insurance approval, I’m convinced I would have lost my leg below the knee – a tremendous expense which they WOULD pay for!”
– Mark H., Brattle Boro, VT

We’re with you on the insurance issue, Mark! For years, ACI Medical has been working to get the ArtAssist® device reimbursed by Medicare and other health insurance providers as a treatment that’s WAY less expensive than amputation.

Clinical studies (including a randomized controlled trial) show that ArtAssist® device therapy is 86%-94% effective at preventing the amputation of limbs that are critically ischemic. This is because the ArtAssist® device was specifically designed to increase arterial blood flow to the lower extremities, providing the nutrients and oxygen necessary to promote healing.

The ArtAssist® device is especially useful for patients who, for some reason, cannot have bypass surgery to restore blood flow.

It is recommended that doctors prescribe ArtAssist® device therapy for their patients 1 hour TID for 90 days and send it along with their patients’ contact information to ACI Medical, where they can also talk to experts on Arterial Pump Technology:

Fax:  (760) 744-4401
Email:  info@acimedical.com
Toll Free:  (888) 453-4356

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Hope in the Face of Amputation: Mary Tells Her Mother’s ArtAssist® Device Story

Diana’s note:  I’ve been digging around on the server lately for material I could use to add to this website. I came across two wonderful stories of patients whose lives were regained because they underwent ArtAssist® Device therapy. These people wished for their testimonials to be shared with others with the hope that anyone suffering from severe PAD would know that there’s one more hope before amputation.

Mary’s mother had run out of options and was on her way toward amputation when doctors suggested the ArtAssist® Device. Here is Mary’s letter to ACI Medical on behalf of her mother (identifying information has been omitted, but it is otherwise unabridged):

November 7, 2006
ACI Medical
1857 Diamond Street
San Marcos, CA 92078-5129

To Whom It May Concern:

A little over three months ago, my mother was an active and independent 83 year-old woman, who lived alone, drove a car and took walks around the block. She began to have a very cold foot, trouble walking and developed pain and ulcers on her left foot and ankle. (She experienced pain just putting a sock on her left foot). She became unable to take her walks, in fact, she would call us because she also experienced intermittent extreme pain and could not move from one room to the next without assistance.

She was diagnosed with peripheral vascular occlusive disease. Several tests and visits to specialists indicated my mother was not a candidate for bypass surgery. Amputation was discussed, which would have been necessary if she developed gangrene. In an effort to avoid amputation, the doctors suggested she take the prescriptions Plavex and Pletal and use the ARTERIAL ASSIST DEVICE.

My mother used the ARTERIAL ASSIST DEVICE along with the Plavex and Pletal for a three-month period. I am happy to report to you that my mother is again an active and independent 83 year-old woman who is taking walks around the block! Thank you to the inventors of the ARTERIAL ASSIST DEVICE!

I am writing this letter so that someone out there who may be as severe as my mother was would ask their doctor about trying this device in an effort to avoid amputation or surgery. Sometimes there is hope when you think hope doesn’t exist.

Sincerely,
Mary H., Southgate, MI

Next week, you’ll read about a patient whose left leg has been saved not once, but twice thanks to ArtAssist® Arterial Pump Technology!

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The ArtAssist® device presented by Dr. Sherif Sultan of the Western Vascular Institute

Dr. Sultan is a consultant vascular and endovascular surgeon who has been studying the ArtAssist® device in a clinical setting at his practice in Galway, Ireland.

An excerpt from his presentation at the 2009 Veith Symposium in New York (note that this is before the final results of this ongoing study were released):

Art-Assist SCBD is a valuable tool in the armamentarium for dealing with CLI patients with un-reconstructable PVD. It gives superior limb salvage, ameliorates amputation free survival, enhances ulcer healing rates, reduces length of hospital stay and provides rapid relief of rest pain without any intervention in patients with limited life expectancy.

http://www.veithsymposium.org/pdf/vei/2852.pdf

artassist compression sequence device

On a related note, Dr. Sultan’s website features a short video about the ArtAssist® device.

For those in Ireland, the ArtAssist® device is distributed by Deprimo, Ltd. (http://deprimo.ie/)

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