Direct evidence of lymphatic function improvement after advanced pneumatic compression device treatment of lymphedema

Abstract

Lymphedema affects up to 50% of all breast cancer survivors. Management with pneumatic compression devices (PCDs) is controversial, owing to the lack of methods to directly assess benefit. This pilot study employed an investigational, near-infrared (NIR) fluorescence imaging technique to evaluate lymphatic response to PCD therapy in normal control and breast cancer-related lymphedema (BCRL) subjects. Lymphatic propulsion rate, apparent lymph velocity, and lymphatic vessel recruitment were measured before, during, and after advanced PCD therapy. Lymphatic function improved in all control subjects and all asymptomatic arms of BCRL subjects. Lymphatic function improved in 4 of 6 BCRL affected arms, improvement defined as proximal movement of dye after therapy. NIR fluorescence lymphatic imaging may be useful to directly evaluate lymphatic response to therapy. These results suggest that PCDs can stimulate lymphatic function and may be an effective method to manage BCRL, warranting future clinical trials.

The Effectiveness of Intermittent Pneumatic Compression in Long-Term Therapy of Lymphedema of Lower Limbs

“…The 5 Well controlled studies have documented its usefulness in the treatment of lower limb lymphedema, thereby supporting their continued use. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] However, no long-term observations have so far been documented. The difference between our and others' studies relied mainly on that we applied long inflation times and relatively high pressures, based on our previously published tissue fluid pressure/flow data.…”

Rare adipose disorders (RADs) masquerading as obesity

“…LDT has been shown to improve skin elasticity, restore the venoarteriolar reflex, increase pre-lymph drainage and lymph transport in lymphatic vessels [116,151] , and reduce capillary fragility in lipedema [152] . Intermittent pneumatic compression may not improve limb size over MLD alone [153] but may be effective alone when MLD is not available [154] . Compression is most effective when tissue edema is present [155] as in its absence, it has little effect [156] .…”

Improvement in Clinical Outcomes, Physical Function, and Bodily Pain Following a 12 Week Course of Intermittent Pneumatic Compression Therapy in Patients with Chronic Venous Ulcers: Results of an Observational Longitudinal Retrospective Study

“…The early IPC pumps employed a single chamber inflation cuff that applied compression to the entire extremity. Subsequent developments in IPC-involved pumps and sleeves with multiple chambers that delivered uniform, sustained segmental compression in a gradient fashion (with pressure in the distal chambers being greater than in the proximal chambers) enabling a sequential mechanism of distal to proximal delivery of compression [13][14][15]. IPC has been shown to accelerate the healing of venous ulcers and alleviate the symptoms of CVI in several clinical studies [16][17][18][19].…”