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.
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.
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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.
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