title: Pneumatic Compression Improves Quality of Life in Patients with Lower-Extremity Lymphedema.
abstract: BACKGROUND
  Lymphedema is an incurable and disfiguring disease secondary to excessive fluid and protein in the interstitium as a result of lymphatic obstruction. Pneumatic compression (PC) offers a novel modality for treatment of lymphatic obstruction through targeting lymphatic beds and mimicking a functional drainage system. The objective of this study is to demonstrate improved quality of life in patients with lower-extremity lymphedema.
  
  
  METHODS
  Consecutive patients presenting to a single institution for treatment of lymphedema were all treated with PC for at least 3 months. All patients underwent a pre- and post-PC assessment of episodes of cellulitis, number of ulcers, and venous insufficiency. Post-PC symptom questionnaires were administered. Symptom improvement was the primary outcome for analysis.
  
  
  RESULTS
  A total of 100 patients met inclusion criteria. At presentation, 70% were female with a mean age of 57.5 years. Secondary lymphedema was present in 78%. Mean length of PC use was 12.7 months with a mean of 5.3 treatments per week. Ankle and calf limb girth decreased after PC use, (28.3 vs. 27.5 cm, P = 0.01) and (44.7 vs. 43.8 cm, P = 0.018), respectively. The number of episodes of cellulitis and ulcers pre- and post-PC decreased from mean of 0.26-0.05 episodes (P = 0.002) and 0.12-0.02 ulcers (P = 0.007), respectively. Fourteen percent had concomitant superficial venous insufficiency, all of whom underwent venous ablation. Overall 100% of patients reported symptomatic improvement post-PC with 54% greatly improved. 90% would recommend the treatment to others.
  
  
  CONCLUSIONS
  PC improves symptom relief and reduces episodes of cellulitis and ulceration in lower-extremity lymphedema. It is well tolerated by patients and should be recommended as an adjunct to standard lymphedema therapy. Screening for venous insufficiency is recommended.
authors.affiliation: Division of Vascular and Endovascular Surgery, NYU Langone Medical Center, New York, NY. Electronic address: Sheila.blumberg@nyumc.org.
authors.forename: Sheila N
authors.initials: SN
authors.lastname: Blumberg
authors.affiliation: Division of Vascular and Endovascular Surgery, NYU Langone Medical Center, New York, NY.
authors.forename: Todd
authors.initials: T
authors.lastname: Berland
authors.affiliation: Division of Vascular and Endovascular Surgery, NYU Langone Medical Center, New York, NY.
authors.forename: Caron
authors.initials: C
authors.lastname: Rockman
authors.affiliation: Division of Vascular and Endovascular Surgery, NYU Langone Medical Center, New York, NY.
authors.forename: Firas
authors.initials: F
authors.lastname: Mussa
authors.affiliation: Division of Vascular and Endovascular Surgery, NYU Langone Medical Center, New York, NY.
authors.forename: Allison
authors.initials: A
authors.lastname: Brooks
authors.affiliation: Division of Vascular and Endovascular Surgery, NYU Langone Medical Center, New York, NY.
authors.forename: Neal
authors.initials: N
authors.lastname: Cayne
authors.affiliation: Division of Vascular and Endovascular Surgery, NYU Langone Medical Center, New York, NY.
authors.forename: Thomas
authors.initials: T
authors.lastname: Maldonado
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D048228:Intermittent Pneumatic Compression Devices; D035002:Lower Extremity; D008209:Lymphedema / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016896:Treatment Outcome; D014689:Venous Insufficiency / Q000453:epidemiology