Effect of Intermittent Pneumatic Compression on the Hemodynamics of Lower Extremity Artery

ABSTRACT

Better understanding of the hemodynamic role of foot and calf pump not only in enhancing the return of lower-limb venous blood, but in fibrinolysis of thrombus motivated the development of intermittent pneumatic compression (IPC) system for limb venous insufficiency. Additionally, IPC treatment have also been investigated with respect to their effect on distal arterial flow in patients with peripheral arterial disease. Some studies investigated the direct effect of IPC on popliteal artery hemodynamics not only in normal individuals, but also in patients with peripheral arterial insufficiency. There are several mechanisms by which a positive effect on the lower limb tissue perfusion is conferred by the use of IPC. These include emptying of the plantar venous plexus, reduction of the venous leg pressure, increase of the arterio-venous pressure gradients in dependent patients, increase of arterial flow, release of vasodilators (nitric oxide - NO, prostacycline), reductin of local vascular resistance, and transient suspension of the arterio-venous reflex. The use of IPC for the treatment of peripheral arterial disease appears to be promosing and may be used in patients with severe peripheral arterial disease (PAD) who are not candidates for revascularization using percutaneous angioplasty or surgey.