Research carried out at the Imperial College in London shows that an intermittent pneumatic compression (IPC) therapy regimen applied to lower limbs with peripheral arterial disease (PAD) can extend the life and efficacity of infrainguinal arterial bypass grafts. Starting with the knowledge that IPC already dramatically enhances blood flow to the lower extremities, researchers in London tested their hypotheses on patients who had already undergone successful bypass surgery in hopes that IPC therapy would improve the performance of the new vascular system. They were not disappointed.
“IPC was effective in improving infrainguinal graft flow velocity, probably by reducing peripheral resistance,” states the last line of one abstract of a study led by Konstantinos Delis, MD, PhD. “IPC has the potential to reduce the risk of bypass graft thrombosis.”
Many patients with ischemic limbs choose to have a bypass procedure done to restore arterial blood flow to their lower extremities. Though bypass procedures are often a reliable treatment solution for limb ischemia, the newly-revascularized limb is still susceptible to returning to its atherosclerotic state if regular blood flow is not maintained.
To prevent return of this disease’s symptoms, some patients are able to exercise regularly. Others, however, remain in danger of being revisited by PAD’s painful consequences.
This is where IPC therapy comes in: by sequentially compressing the foot, ankle and calf, IPC mimics the physiological benefits of taking a brisk walk. Both walking and IPC activate the calf muscle pump, which pushes venous blood back towards the heart to be re-oxygenated and sent back to the legs at a greater velocity. This increase in blood flow effectively increases chances of recovery from the effects of PAD.
In one study, researchers at the Imperial College of London applied an IPC device to patients who had already successfully undergone an arterial bypass graft (femoropopliteal & femorodistal). Five outcome measures, including volume flow in the grafts, yielded encouraging results directly after IPC therapy. Blood flow had improved significantly in all areas for both types of bypass grafts.
Having one more option for maintaining healthy blood flow to the lower limbs could dramatically change a PAD patient’s quality of life by decreasing the number of surgical procedures and time spent in the hospital.
The IPC device used in this clinical study was the ArtAssist® Arterial Pump developed by ACI Medical, LLC.
Haemodynamic Effect of Intermittent Pneumatic Compression of the Leg After Infainguinal Arterial Bypass Grafting. Delis, K. et al. St. Mary’s Hospital, Imperial College School of Medicine, London, UK. Br J Surg 2004; 91: 429-34
Other studies of interest:
Enhancing Foot Skin Blood Flow in Patients with Infrainguinal Arterial Bypass Grafting Using Intermittent Pneumatic Compression. Husmann, M.J.W.; Delis, K.T.; Lennox, A.F.; Nicolaides, A.N.; Standsby, G. Irvine Laboratory for Cardiovascular Research, St. Mary’s Hospital, London, UK. 21st Conference in Microcirculation, June 2000
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
Enhancing Foot Skin Blood Flux in Peripheral Vascular Disease Using Intermittent Pneumatic Compression: Controlled Study on Claudicants and Grafted Arteriopaths. Delis, K.T.; Husmann, M.J.W.; Nicolaides, A.N.; Wolfe. J.H., and Cheshire, N.J., Imperial College School Of Medicine, St. Mary’s Hospital, London, UK. World Journal Surgery, 2002 Jul;26(7):861-6