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Big meetings this week: Desert Foot & VEITHsymposium™

Starting tomorrow, two very important meetings will kick off and experts from ACI Medical will be attending both of them.

If you are attending Desert Foot 2012, the 9th Annual High Risk Diabetic Foot Conference, be sure to attend the 20 minute presentations given by Dr. Darwin Eton (University of Chicago) and Dr. Paul van Bemmelen (Temple University). Both will be talking about how pneumatic compression therapy with arterial pump technology can prevent amputations in non-reconstructible limbs. Both have extensive experience using the ArtAssist® device in a clinical setting.

Here is when you can hear them talk:

Paul van Bemmelen, MD
Wednesday, November 14 from 2:10 PM to 2:30 PM “Pneumatic Compression for Non-Reconstructible PAD”

Darwin Eton, MD
Thursday, November 15 from 5:45 PM to 6:05 PM “Combined Cell Therapy and Pneumatic Compression to Treat Limb Ischemia”

VEITHsymposium™ 2012 will be featuring Professor Andrew Nicolaides of the Imperial College of London. He has been invited to discuss non-reconstructible limb salvage using arterial pump technology during a 5 minute talk on Friday, November 16 from 6:46 AM to 6:51 AM (don’t forget to drink your coffee – hearing him talk is always a treat!). Professor Nicolaides has clinical experience with the ArtAssist® device as well.

As pioneers of ArtAssist®…The Arterial Assist Device® technology, we at ACI Medical invite and encourage you to contact us with your questions about anything from the device’s science to ordering one for your patient:
(888) 453-4356 or info@acimedical.com

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Nov 13, 2012 By ArtAssist®...The Arterial Assist Device®, Diabetic Foot, PAD

“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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Sep 25, 2012 By ArtAssist®...The Arterial Assist Device®, PAD

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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Sep 25, 2012 By ArtAssist®...The Arterial Assist Device®, PAD

“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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Sep 7, 2012 By ArtAssist®...The Arterial Assist Device®, PAD

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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Aug 16, 2012 By ArtAssist®...The Arterial Assist Device®, PAD

Andrew Nicolaides scheduled to talk about the ArtAssist® Device at Veith Symposium 2012

We are excited to announce that at this year’s Veith Symposium in New York, Professor Nicolaides will be giving a short presentation about our own ArtAssist® pneumatic compression device.

As one of the ArtAssist® Device’s key developers, Prof. Nicolaides is a veritable expert on the machine’s capability to treat non-surgical patients suffering from severe PAD. If anyone can give a great 5-minute talk about our new technology at 6:46 a.m., it would be him.

Are you attending Veith 2012? Roll out of bed, grab some coffee (or whatever you do to wake up…I don’t judge), get dressed with as much coordination as you can muster, and make your way down to the lecture hall on Friday, November 16 from 6:46 – 6:51 a.m. to listen to “How The Art-Assist Pneumatic Compression Device Can Heal Ulcers From CLI And Relieve Rest Pain Noninvasively.”

As a man of vast knowledge, Prof. Nicolaides will also be presenting on a couple of other topics. Check out his schedule by clicking here.

Related articles
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Jul 17, 2012 By ArtAssist®...The Arterial Assist Device®

Why ArtAssist® arterial pump therapy is unique

When you think of therapeutic pneumatic compression pumps, what comes to mind? Many might think of lymphedema or DVT prophylaxes, but it is less widely-known that arterial pump compression therapy, if correctly applied, can actually treat severe PAD.

ArtAssist Arterial Assist Device

ArtAssist®…The Arterial Assist Device®

ArtAssist®…The Arterial Assist Device® (Arterial Pump Technology) should not be confused with lymphedema or DVT prevention treatment because the ArtAssist® device solves an entirely different problem:  facilitating arterial blood flow to the places that need it, especially in the legs and feet (there are also cuffs available for arms, though it is somewhat less common).

So, for example, if you have atherosclerosis (hardening of the arteries) of the lower extremity or a diabetic foot ulcer, your problems would not be solved with a lymphedema pump, even if it has been modified to be more powerful. (Side note:  some arterial pump makers advertise that a more powerful lymphedema or DVT pump will effectively treat arterial disease. We at ACI Medical suggest that you ask for their clinical evidence.)

Depending on the nature and severity of your arterial disease, you may be better advised to use the ArtAssist® device. This device was not based on a lymphedema or DVT pump design – rather, the ArtAssist® device was designed by vascular surgeons with the goal of increasing arterial flow for patients with poor leg circulation.

Researchers have discovered that, unlike lymphedema pump technology, the ArtAssist® device promotes what we call arteriogenesis, or collateralization.  These two synonyms refer to the opening of small collateral arteries that already naturally bypass the obstructed artery. We all have these small collateral arteries, but when the main artery has no blockages, the collateral ones aren’t needed.

angiogram van bemmelen artassist arterial pump technology

Arteriogenesis (or collateralization) explains why patients have long-term results after stopping ArtAssist® device usage

In this case, a person with a blocked artery needs to take action so that blood gets where it needs to be. Sometimes, people make lifestyle changes, such as dieting and exercising. Other times, people take medication to improve blood flow. And in more severe cases, people resort to surgery such as bypass and endovascular procedures (e.g. stenting, angioplasty, etc.).

The problem is that some people exhaust all of those options and vascular surgeons believe they have no other choice but to amputate – but that’s not true! There is actually one last shot at limb salvage for these patients, and that is the ArtAssist® device. In one clinical study, it was shown to have up to a 94% limb salvage rate even after 3.5 years.

Do be advised, though:  no one would ever recommend that you let it get to the point of amputation. As with all diseases, the earlier you solve the problem, the better.

If you or someone you know could use the ArtAssist® device as a non-surgical solution for PAD, please call our toll free number 888-453-4356 and ask to talk to Don or Sylvia. If you contact me (via WordPress, Twitter, Facebook, email, website, etc.), I will refer you to either of the two people I just mentioned as quickly as I can – we know how important limb salvage is.

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Jun 4, 2012 By ArtAssist®...The Arterial Assist Device®

Compressing the foot and why it’s so important

Why calf-only arterial pumps are missing out

ArtAssist device compression sequence

ArtAssist®…The Arterial Assist Device® Compression Sequence

Calf-only arterial pumps are missing a key component because foot compression is essential to improving circulation in the skin of the foot. Good circulation is vital to the successful healing wounds and ulcers. ACI Medical’s ArtAssist® device went through numerous clinical trials in order to optimize compression therapy for treating peripheral arterial disease of the legs and feet.

Researchers and engineers optimizing the ArtAssist® device not only discovered the importance of compressing the foot in addition to the calf, but they also designed this arterial pump technology to imitate the physiological act of walking as closely as possible.

A bit of background

An early study to determine the physiological effects of  intermittent pneumatic compression therapy focused compression on the calf, foot, and both simultaneously.

Although significant increase in arterial blood flow was recorded for individual compression areas, the simultaneous combination yielded disappointing results because blood was not flowing back to the heart as anticipated.

After the conclusion was drawn that simultaneous compression did not produce the desired augmented blood flow for all tissues below the knee, researchers realized that the answer lay in a time delay. Strong, encompassing foot and ankle compression that boosts foot skin perfusion would come first, followed then by calf compression to amplify popliteal flow.

That magical formulation

In essence, foot/ankle compression + calf compression with time delay = successful emptying of venous blood, resulting in improved circulation.

The optimization study led by K. T. Delis, et. al. determined that this foot, ankle and calf compression sequence, applying 120-140 mmHg at a frequency of 3-4 impulses per minute, “provided the optimum intermittent pneumatic stimulus.”

The next logical step was a prospective randomized controlled trial to solidify the efficacy claims.

And the rest is history…

One example of such a trial studied not only the effects of the previously mentioned IPC method, but also the long-term effects on treated claudicants. The results indicated that treated claudicants still retained their ABI’s and walking benefits one year after the end of IPC application.

Following the numerous physiological and optimization studies for the ArtAssist® device, research facilities continued to explore the possibilities of arteriogenesis, therapy for patients with intermittent claudication, and limb salvage.

The ArtAssist® device is currently the only IPC device with this thorough progression of clinical studies and randomized controlled trials to support its efficacy.

References

  1. “Improving Popliteal Artery Flow with Intermittent Pneumatic Foot and Calf Compression.” Delis, K.; Labropoulos, N.; Nicolaides, A.N.; Stansby, G.; and Lumley, J. Irvine Laboratory for Cardiovascular Investigation and Research, Academic Surgical Unit, Imperial College School of Medicine, St. Mary’s Hospital, London, UK.
  2. “Enhancing Venous Outflow in the Lower Limb with Intermittent Pneumatic Compression. A Comparative Haemodynamic Analysis on the Effect of Foot vs. Calf vs. Foot and Calf Compression.” Delis, K.T.; Slimani, G.; Hafez, H.M. and Nicolaides, A.N. Irvine Lab for Cardiovascular Investigation and Research, Academic Vascular Unit, Imperial College School of Medicine, St. Mary’s Hospital, London UK. Eur J Vasc Endovasc Surg 19, 250-260; 2000
  3. “The Acute Effects of Intermittent Pneumatic Foot and Calf Compression on Popliteal Artery Hemodynamics: A Comparative Study.” Delis, K.T.; Nicolaides, A.N.; Labropoulos, N.; and Stansby, G. Imperial College School of Medicine, St. Mary’s Hospital, London, UK. J Vasc Surg, 2000; 32: 284-92
  4. “Intermittent Calf and Foot Compression Increases Lower Extremity Blood Flow.” Eze, A.R.; Comerota, A.J.; Cisek, P.L.; Holland, B.S.; Kerr, R.P.; Veeramasuneni, R.; Comerota, A.J. Jr. Presented at the 24th Annual meeting of the Society for Clinical Vascular Surgery; March 1996. Am J Surg 1996; 172:130-135
  5. “Optimum Intermittent Pneumatic Compression Stimulus for Lower-limb Venous Emptying.” Delis, K.T.; Azizi, A.A.; Stevens, R.J.G.; Wolfe, J.H.N.; Nicolaides, A.N. Eur J Vasc Endovasc Surg 19, 261-269 (2000).
  6. “Improvement in Walking Ability, Ankle Pressure Indices and Quality of Life in Vascular Claudication Using Intermittent Pneumatic Foot and Calf Compression; A Prospective Randomized Controlled Trial with 1 Year Follow-up.” Delis, K.T.; Nicolaides, A.N.; Cheshire, N.J.W.; and Wolfe, J.H.N. Academic Vascular Surgery, St. Mary’s Hospital, London, UK. Presented at the Vascular Surgical Society of Great Britain & Ireland, Nov. 2000, London Arena.
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May 25, 2012 By ArtAssist®...The Arterial Assist Device®

Challenge conventions. You may end up saving a limb!

Previously, I posted a whole article about how it’s actually not dangerous to use compression therapy on an ischemic limb. However, that’s not the only misconception that we’ve cleared up at ACI Medical. This article exposes a couple more myths that have been known to float around, and how we’ve found evidence to set the record straight.

Even after some experts dismissed the idea of intermittent pneumatic compression (IPC) as a viable treatment for patients with PAD, the creators and developers of the ArtAssist® device put their theories to the test nonetheless.

Pioneered and developed with vascular surgeons, the ArtAssist® device continues to be the leader in IPC therapy for non-surgical PAD patients with varying levels of severity.

ArtAssist® IPC therapy should not be overlooked or dismissed without having considered the clinical evidence:

in fact, it has both saved limbs and improved patient quality of life.

MYTH: Critically ischemic limbs are maximally vasodilated.

False.

In fact, the ArtAssist® device’s first physiological clinical trial disproves this myth. Even without having been optimized to the extent it is now, the prototype yielded results that suggested transient vasodilation.

Later, in 2005, a study conducted by Professor Labropoulos of SUNY not only confirms the earlier findings, but also suggests that increasing the arteriovenous pressure gradient with foot & calf IPC therapy contributes greatly to significantly increased blood flow in the subjects’ popliteal, gastrocnemial and collateral arteries. Skin blood flow also improved significantly in their findings.

MYTH: The ArtAssist® device is the same as any other arterial pump with similar function.

False.

We encourage you to ask yourself these two important questions when considering other devices which claim to perform as efficaciously as the ArtAssist® device:

1. Is it optimized for arterial disease? And

2. Is there clinical evidence and support for this specific device?

Only the ArtAssist® device satisfies each of these questions with its thorough progression of clinical studies: this device alone has been adjusted and optimized from its initial prototype over the past two decades to effectively treat even the most severe cases of PAD.

  • Physiological
  • Optimization
  • Intermittent Claudication
  • Limb Salvage
  • Critical Limb Ischemia (CLI)
  • Arteriogenesis (Collateralization)

Currently, studies are being conducted to explore the ArtAssist® device’s efficacy for adjunct therapies, such as stem cell treatment and gene expression.

The Bottom Line.

Your patient’s non-reconstructable limb will not wait for hearsay on this form of therapy.

We are here to let you know that therapy with the ArtAssist® device gives patients a dependable option that continues to help non-surgical limbs across the country.

Make the decision that could save your patient from amputation.

References

Augmentation of blood flow in limbs with occlusive arterial disease by intermittent calf compression. Van Bemmelen, P.S.; Mattos, M.A.; Faught, W.E.; Mansour, M.A.; Barkmeier, L.D.; Hodgson, K.J.; Ramsey, D.E.; and Sumner, D.S. Springfield, IL. Journal of Vascular Surgery 1994; 19:1052-8.

Hemodynamic effects of intermittent pneumatic compression in patients with critical limb ischemia. Labropoulos, N.; Leon, L.R.; Bhatti, A.; Melton, S.; Kang, S.S.; Mansour, A.M.; and Borge, M. The Department of Surgery, Loyola University Medical Center, Maywood, IL. Journal of Vascular Surgery, October 2005; Volume 42, Number 4: 710-716

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May 25, 2012 By ArtAssist®...The Arterial Assist Device®

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