Intermittent pneumatic compression for the treatment of lower extremity arterial disease: a systematic review

Abstract

This study aimed to identify the role of intermittent pneumatic compression in treating peripheral arterial disease and to investigate the types of treatment programs that are most effective. Data was sourced from English-language articles which were identi ed by a computer search using MEDLINE from 1966 to 2001, followed by extensive bibliography review. Studies were included if they contained pertinent material involving a compression device and arterial ow dynamics in lower limbs. A total of 26 English-language studies were identi ed that met the inclusion criteria. The diverse patient criteria and methods used in the studies provided an opportunity to examine the effectiveness of each, but made it dif cult to compare one study with another. To assist in focusing on overall trends in improvement, patient type and treatment type disparities must be identi ed. In conclusion, it is evident that an intermittent pneumatic compression program appears promising and may be used in patients with severe peripheral arterial disease who are not candidates for revascularization using surgery or percutaneous angioplasty. It is now the goal to establish randomized, prospective, controlled trials to clarify the most bene cial regimen for treating such disease.

A prospective randomized controlled study with intermittent mechanical compression of the calf in patients with claudication

“…These treatment parameters were selected according to prior studies in which the impact of IMC on popliteal arteral flow was optimized. 7 The device also includes integrated software that records the duration of use for each day and allows monitoring of the degree of compliance with the prescribed two hour/day, seven days/week, three-month treatment prescription. In order to assess compliance in an unbiased way, the patients were not informed of the existence of this software during the study.…”

“…6 Prior studies have also demonstrated that IPC increases lower limb arterial flow and could therefore be useful in patients with PAD. 7 Indeed, therapeutic effects have been identified in studies showing a 3.2 Ϯ 1.6-fold increase in resting popliteal artery blood flow in patients with claudication in response to IPC applied to the calf 8 and isotope studies showing an increase in calf muslce perfusion with IPC applied to the foot. 9 Although promising, the use of IPC devices for claudication has not been pursued extensively because of certain limitations.…”

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

“…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.…”

Diabetic foot disease and oedema

“…Claudication distance, rest pain, and rates of limb salvage were improved across the spectrum of trials performed, associated with increased arterial blood flow, peak systolic velocity, end diastolic velocity and pulse volume. 48 A small randomized study with 12 months follow-up (n=30) in patients with stable intermittent claudication concluded that walking distance improved in these patients. 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.…”