A Review of the Evidence to Support Neuromuscular Electrical Stimulation in the Prevention and Management of Venous Disease.
The prevention and management of venous disease is a therapeutic challenge. Movement of blood through the venous system is augmented by the action of muscles on the deep veins, and can be achieved through the application of electrical current. The efficacy of currently available clinical devices for this purpose is unknown, and is investigated here.



A literature search of the EMBASE and Medline databases was performed, and studies were included if they were full text articles, written in english, pertaining to venous disease and neuromuscular electrical stimulation (NMES).



NMES devices increase venous haemodynamic parameters such as peak velocity and volume flow. Studies report them to be non-inferior to intermittent pneumatic compression. They are effective in the prevention of venous thromboembolism, though inferior to low molecular weight heparin. NMES can reduce symptoms of chronic venous disease.



NMES is an important tool in the prevention and management of venous disease, and avoids the significant risks associated with heparin administration. Data explored here is heterogenous in device, protocol, and reported end-points, therefore should be interpreted with care. Long term effects of treatment with NMES have not been explored.
Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College London, London, UK.
K J
KJ
Williams
Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College London, London, UK.
R
R
Ravikumar
Department of Vascular Surgery, University of Alexandria, Alexandria, Egypt.
A S
AS
Gaweesh
Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College London, London, UK. hayley.moore03@imperial.ac.uk.
H M
HM
Moore
Servicio de Cirugía General, Sector Flebolinfología, Hospital Italiano, Buenos Aires, Argentina.
A D
AD
Lifsitz
Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College London, London, UK.
T R A
TR
Lane
Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College London, London, UK.
J
J
Shalhoub
Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College London, London, UK.
A
A
Babber
Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College London, London, UK.
A H
AH
Davies
D004558:Electric Stimulation; D006439:Hemodynamics; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D009131:Muscle, Smooth, Vascular / Q000502:physiology; D009469:Neuromuscular Junction / Q000502:physiology; D053828:Stockings, Compression; D016896:Treatment Outcome; D014680:Veins / Q000473:pathology; D054556:Venous Thromboembolism / Q000473:pathology / Q000517:prevention & control / Q000628:therapy*; D020246:Venous Thrombosis / Q000473:pathology / Q000517:prevention & control / Q000628:therapy*
D006495:Heparin, Low-Molecular-Weight
Electrical stimulation; Heparin; Thrombosis; VTE; Venous