Rapid intermittent compression increases skin circulation in chronically ischemic legs with infra-popliteal arterial obstruction.
BACKGROUND
Intermittent pneumatic compression (IPC) has been shown, by duplex, to increase popliteal artery flow in normal legs and in legs with superficial femoral artery occlusion. The objective of this study was to see if IPC improves distal circulation in legs with severe infra-popliteal disease.


METHODS
Sixteen chronically ischemic legs with arteriographically demonstrated crural or pedal disease were studied during compression with an ArtAssist compression-device. This device delivers rapid compression of the foot and calf. Cutaneous laser-Doppler flux was measured continuously at the dorsal aspect of the distal forefoot. The findings were compared to those in thirteen normal controls of similar age.


RESULTS
In ischemic legs, the spontaneous changes in skin-flux are minimal: mean resting flux in sitting position was 0.87 +/- 0.46 AU (Arbitrary Units). Upon activation of the compression device the maximum flux increased to 4.55 +/- 1.35 AU. The difference was statistically significant (p < 0.001). This response was similar to that in normal controls.


CONCLUSIONS
Arterial flow augmentation upon compression is associated with increased skin-flux. This response remains present in severe disease of the crural outflow-arteries. Further investigation to define the role of intermittent compression for management of chronic arterial disease is warranted.
van Bemmelen
P S
PS
Division of Vascular Surgery, State University of New York, Stony Brook, USA.
Weiss-Olmanni
J
J
Ricotta
J J
JJ
D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages; D001783:Blood Flow Velocity / Q000502:physiology; D005260:Female; D005528:Foot / Q000098:blood supply; D006801:Humans; D007511:Ischemia / Q000503:physiopathology / Q000628:therapy*; D017078:Laser-Doppler Flowmetry; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000098:blood supply*; D016896:Treatment Outcome