Effect of foot compression on the velocity and volume of blood flow in the deep veins

Abstract

The A-V Impulse System reduces the incidence of deep vein thrombosis by pneumatically compressing the venae comitantes of the lateral plantar artery, causing an increase in the velocity of blood in the proximal axial veins. Using a duplex scanner the effects of altering the pressure, pulse duration and frequency of foot compression on the velocity and volume of blood flow in the superficial femoral and popliteal veins were quantified. In 20 legs, foot compression of 50, 125 and 200 mmHg significantly increased the maximum venous blood flow by 9.0, 13.4 and 15.1 ml/s respectively (P < 0.001). Conversely, reducing the frequency of compression from 6 to 3 cycles per min significantly increased the rise in peak flow from 10.1 to 14.8 ml/s (P < 0.001). Changing the duration of compression from 1 to 3 s had no significant effect on peak flow. Increased blood flow is best achieved with high-pressure low-frequency foot compression. Increasing the duration of compression beyond 1 s has no effect on augmentation of flow in the deep veins.

Acute Effects of Intermittent Pneumatic Compression on Popliteal Artery Blood Flow

“…Foot and/or calf compression has been shown to augment popliteal artery blood flow in both normal volunteers and patients with peripheral arterial disease. 19 While it has been hypothesized that the increase in blood flow is a result of a reduction in the arteriovenous pressure gradient, 8,[10][11][12][13]15,16 there are no studies to our knowledge to confirm this hypothesis. Furthermore, previous studies have used duplex ultrasonography to determine the effects of intermittent pneumatic compression on popliteal artery blood flow, although the reproducibility of this method in this arterial segment has not been determined.…”

Foot pumps without graduated compression stockings for prevention of deep-vein thrombosis in total joint replacement: efficacy, safety and patient compliance

“…Results from four independent randomised clinical trials have shown that mechanical prophylaxis with foot pumps in THR achieved equivalent -if not superior -results compared to chemical management [5,11,13,16], but the tolerance of the device has been a problem for some patients [3,12]. The effective action of the foot pumps depends on various factors, including the frequency and pressure of the impulses and the dependency of the lower extremities [1,4,10]. It is not known whether the efficacy, safety and compliance of the foot pumps are enhanced by the simultaneous use of graduated compression stockings (GCS).…”

Evidence-Based Compression

“…The size, duration, and profile of that augmentation will be dependent on the particular compression system that is used. Changes have been observed in the femoral vein, as a result of calf and thigh compression, 10 -17 and of foot compression; 14 -19 in the popliteal vein due to calf compression, 13,15,16 and foot compression; 13,15,16,18,19 and in the posterior tibial vein after foot compression. 13,19 It is, of course, difficult to measure changes in the popliteal vein with most thigh-length cuffs, just as measurements in the posterior tibial vein would not describe outflow effects when thigh or calf-length garments are used.…”