Effect of Intermittent Pneumatic Compression of Foot and Calf on Walking Distance, Hemodynamics, and Quality of Life in Patients With Arterial Claudication

Delis, Konstantinos T.; Nicolaides, Andrew

doi:10.1097/01.sla.0000154358.83898.26

Cited by 70 publications

(72 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…49 In addition to improved walking distance in stable claudicants, a prospective randomised controlled study with 1 year follow-up found an improvement in the ankle brachial pressure index, which is a measurement of peripheral haemodynamics, and improvement in quality of life. 50 A more recent study in patients with chronic lower limb ischaemia found a significant improvement in wound healing and limb salvage rates in the treated group. The intermittent pneumatic compression was delivered at an inflation pressure of 85-95mmHg, applied for 2 seconds with rapid rise (0.2 seconds), three cycles per minute, for three 2-hourly sessions per day.…”

mentioning

confidence: 99%

Diabetic foot disease and oedema

Leigh

Tsui

2013

Diabetes & Vascular Disease

View full text Add to dashboard Cite

Diabetic foot ulcers (DFUs) are common and disabling, giving rise to significant morbidity and mortality as well as worldwide socioeconomic problems. Despite treatment, DFUs readily become chronic wounds and may lead to major lower limb amputations. The pathogenesis of DFUs is complex and the main aetiologies are peripheral neuropathy, ischaemia from peripheral arterial disease and biomechanical abnormalities. Microvascular disease is also a significant problem for people with diabetes and contributes to foot ulceration. Successful management of DFUs consists of debridement, infection control, the use of offloading appliances and revascularisation where necessary. Foot ulcers are usually associated with infection and inflammation which lead to surrounding oedema of the foot. Standard offloading devices such as total contact casts and removable cast walkers do not actively reduce foot oedema. There is promising evidence that active oedema reduction by intermittent pneumatic compression in the diabetic foot improves ulcer healing. The objective of this article is to review the association of foot oedema and DFUs, including the role of appliances which reduce oedema. The information presented is vital to those involved in the management of DFUs.

show abstract

mentioning

confidence: 99%

Diabetic foot disease and oedema

Leigh

Tsui

2013

Diabetes & Vascular Disease

View full text Add to dashboard Cite

show abstract

“…In recent years, evidence has been provided showing that this strategy is an efficacious therapeutic option for patients with peripheral artery disease (PAD) (11,13,24). In a randomized controlled trial, Delis and Nicolaides (13) showed that a minimum of 2.5 h of daily IPC application for 5 mo improves walking distance, ankle brachial index, and quality of life in stable claudicants.…”

mentioning

confidence: 99%

Intermittent pneumatic leg compressions acutely upregulate VEGF and MCP-1 expression in skeletal muscle

Roseguini

Soylu

Whyte

et al. 2010

American Journal of Physiology-Heart and Circulatory Physiology

View full text Add to dashboard Cite

Roseguini BT, Soylu SM, Whyte JJ, Yang HT, Newcomer S, Laughlin MH. Intermittent pneumatic leg compressions acutely upregulate VEGF and MCP-1 expression in skeletal muscle. Am J Physiol Heart Circ Physiol 298: H1991-H2000, 2010. First published March 26, 2010; doi:10.1152/ajpheart.00006.2010.-Application of intermittent pneumatic compressions (IPC) is an extensively used therapeutic strategy in vascular medicine, but the mechanisms by which this method works are unclear. We tested the hypothesis that acute application (150 min) of cyclic leg compressions in a rat model signals upregulation of angiogenic factors in skeletal muscle. To explore the impact of different pressures and frequency of compressions, we divided rats into four groups as follows: 120 mmHg (2 s inflation/2 s deflation), 200 mmHg (2 s/2 s), 120 mmHg (4 s/16 s), and control (no intervention). Blood flow and leg oxygenation (study 1) and the mRNA expression of angiogenic mediators in the rat tibialis anterior muscle (study 2) were assessed after a single session of IPC. In all three groups exposed to the intervention, a modest hyperemia (ϳ37% above baseline) between compressions and a slight, nonsignificant increase in leg oxygen consumption (ϳ30%) were observed during IPC. Compared with values in the control group, vascular endothelial growth factor (VEGF) and monocyte chemotactic protein-1 (MCP-1) mRNA increased significantly (P Ͻ 0.05) only in rats exposed to the higher frequency of compressions (2 s on/2 s off). Endothelial nitric oxide synthase, matrix metalloproteinase-2, and hypoxia-inducible factor-1␣ mRNA did not change significantly following the intervention. These findings show that IPC application augments the mRNA content of key angiogenic factors in skeletal muscle. Importantly, the magnitude of changes in mRNA expression appeared to be modulated by the frequency of compressions such that a higher frequency (15 cycles/min) evoked more robust changes in VEGF and MCP-1 compared with a lower frequency (3 cycles/min).angiogenesis; intermittent pneumatic compression; vascular endothelial growth factor; monocyte chemotactic protein-1

show abstract

“…12 When used in populations with PAD and claudication, intermittent pneumatic compression of the foot improved pain-free walking distance, anklebrachial index measurements, and quality of life in a small, randomized trial. 13 The utility of intermittent pneumatic compression has also been demonstrated for patients with critical limb ischemia and non-healing wounds. 14 The efficacy of EECP may theoretically be reduced in patients with PAD because of impaired diastolic cuff augmentation during the procedure due to arterial lumen stenoses or occlusion, resulting in attenuation of pressure transmission from the pneumatic cuffs to the central circulation.…”

Section: Discussionmentioning

confidence: 99%

The efficacy and safety of enhanced external counterpulsation in patients with peripheral arterial disease

et al. 2009

View full text Add to dashboard Cite

Peripheral arterial disease (PAD) is common in patients with severe coronary artery disease (CAD) and is considered a relative contraindication to external enhanced counterpulsation (EECP), but there are no data that define the efficacy and safety of EECP in patients with PAD. The International EECP Patient Registry (IEPR) was used to compare initial posttherapy and 2-year follow-up clinical outcomes and adverse event rates in patients with and without PAD. From January 2002 to October 2004, 2126 patients were enrolled in the IEPR, of whom 493 (23%) had a history of PAD. Immediately following EECP, the reduction in angina (≥ 1 Canadian Cardiovascular Society class) was similar in patients with and without PAD (76.6% vs 79.0%, p = 0.27) as was improvement in the Duke Activity Score Index (DASI) score (+4.7% vs +6.1%, p < 0.001). Both angina reduction and DASI score improvement were sustained at 2 years. PAD patients discontinued EECP more frequently (12.0% vs 8.5%, p < 0.05), but lower extremity ulceration did not occur more frequently in patients with PAD (3.7% vs 2.7%, p = 0.26). Rates of death (17.1% vs 8.6%, p < 0.001) and myocardial infarction (9.5% vs 5.0%, p < 0.001) were, as expected, higher in patients with PAD compared to patients without PAD at 2 years. In conclusion, while PAD patients constitute a high-risk cohort with known higher adverse event rates, EECP led to similar short-and longterm improvements in angina and quality of life for individuals with PAD compared to those without PAD.

show abstract

Effect of Intermittent Pneumatic Compression of Foot and Calf on Walking Distance, Hemodynamics, and Quality of Life in Patients With Arterial Claudication

Cited by 70 publications

References 49 publications

Diabetic foot disease and oedema

Diabetic foot disease and oedema

Intermittent pneumatic leg compressions acutely upregulate VEGF and MCP-1 expression in skeletal muscle

The efficacy and safety of enhanced external counterpulsation in patients with peripheral arterial disease

Contact Info

Product

Resources

About