Number 6
INTERMITTENT PNEUMATIC FOOT AND CALF COMPRESSION:
DETERMINING ITS OPTIMAL EFFECT ON VENOUS HEMODYNAMICS
USING DIRECT PRESSURE MONITORING
Kostantinos Delis, M.D., Zainal A. Azizi, MSc, Roger J. G. Stevens, MSc, Kenneth E. Otah, M.D., Veronica Ibegbuna, BSc, Andrew N. Nicolaides, M.D., London, UK
Presented at the American Venous Forum 10th Annual Meeting,
Lake Buena Vista, FL., Feb. 19-21, 1998
Introduction: Recently published data indicates that intermittent pneumatic compression (IPC) of the leg is not only an established method for the prevention of deep vein thrombosis, but also a promising treatment option in the conservative management of symptomatic peripheral vascular disease. The cardinal mechanism explaining its efficacy is believed to be due to enhanced emptying of the dorsal venous plexus of the foot and the muscular and crural veins of the calf.
Aim: To determine the combination of applied pressure, frequency and proximal inflate delay time (PIDT; defined as the time after which calf inflation follows that of the foot) of IPC delivered to the foot and calf (IFCF+C) which optimises lower limb venous emptying, using continuous direct venous pressure monitoring.
Method: IPCF+C was delivered using the ArtAssist (AA-1000, ACI Medical, USA). Six legs of normal subjects [medium age (range) of 30 (24-35) years] free of venous reflux, as determined by duplex (HP Sonos 2500), were investigated. Venous pressure in the sitting position was measured directly in a dorsal vein of the foot using an accurately calibrated pressure transducer (S and W Medico Teknik, Denmark) attached to a 20-gauge heparinized cannula. The effect of IPCF+C at 5 different applied pressures (60, 80, 100, 120 and 140 mmHg), 3 different frequencies (2, 3 and 4 impulses/min) and 3 different PIDTs (0, 0.5 and 1 sec) were evaluated in all possible combinations. After delivery of an impulse, venous pressure declined to a minimum (Pmin) and rose to a maximum (Pmax) just before the next impulse was delivered. The characteristic steady state Pmin and Pmax for a certain combination of pressure, PIDT and frequency were used in the analysis (statistics were performed using the Wilcoxon test).
ACI Medical, LLC
1857 Diamond St.
San Marcos, CA 92078
Tel: (760) 744-4400 Fax: (760) 744-4401
Toll Free: 888 4 LEG FLO (4534356)
E-mail: info@acimedical.com
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Number 6
INTERMITTENT PNEUMATIC FOOT AND CALF COMPRESSION:
DETERMINING ITS OPTIMAL EFFECT ON VENOUS HEMODYNAMICS
USING DIRECT PRESSURE MONITORING
Kostantinos Delis, M.D., Zainal A. Azizi, MSc, Roger J. G. Stevens, MSc, Kenneth E. Otah, M.D., Veronica Ibegbuna, BSc, Andrew N. Nicolaides, M.D., London, UK
Presented at the American Venous Forum 10th Annual Meeting,
Lake Buena Vista, FL., Feb. 19-21, 1998
Introduction: Recently published data indicates that intermittent pneumatic compression (IPC) of the leg is not only an established method for the prevention of deep vein thrombosis, but also a promising treatment option in the conservative management of symptomatic peripheral vascular disease. The cardinal mechanism explaining its efficacy is believed to be due to enhanced emptying of the dorsal venous plexus of the foot and the muscular and crural veins of the calf.
Aim: To determine the combination of applied pressure, frequency and proximal inflate delay time (PIDT; defined as the time after which calf inflation follows that of the foot) of IPC delivered to the foot and calf (IFCF+C) which optimises lower limb venous emptying, using continuous direct venous pressure monitoring.
Method: IPCF+C was delivered using the ArtAssist (AA-1000, ACI Medical, USA). Six legs of normal subjects [medium age (range) of 30 (24-35) years] free of venous reflux, as determined by duplex (HP Sonos 2500), were investigated. Venous pressure in the sitting position was measured directly in a dorsal vein of the foot using an accurately calibrated pressure transducer (S and W Medico Teknik, Denmark) attached to a 20-gauge heparinized cannula. The effect of IPCF+C at 5 different applied pressures (60, 80, 100, 120 and 140 mmHg), 3 different frequencies (2, 3 and 4 impulses/min) and 3 different PIDTs (0, 0.5 and 1 sec) were evaluated in all possible combinations. After delivery of an impulse, venous pressure declined to a minimum (Pmin) and rose to a maximum (Pmax) just before the next impulse was delivered. The characteristic steady state Pmin and Pmax for a certain combination of pressure, PIDT and frequency were used in the analysis (statistics were performed using the Wilcoxon test).
ACI Medical, LLC 1857 Diamond St. San Marcos, CA 92078 Tel: (760) 744-4400 Fax: (760) 744-4401 Toll Free: 888 4 LEG FLO (4534356) E-mail: info@acimedical.com |