Effect of Therapy With the Pneumatic End-Diastolic Leg Compression Boot on Peripheral Vascular Tests and on the Clinical Course of Peripheral Vascular Disease
Restricted accessResearch articleFirst published online September, 1980
Effect of Therapy With the Pneumatic End-Diastolic Leg Compression Boot on Peripheral Vascular Tests and on the Clinical Course of Peripheral Vascular Disease
The Circulator Boot™ is a new end-diastolic pneumatic leg compression device. This report describes its effect on 6 normal young people, 8 ambulatory patients with mild peripheral arterial disease, and 21 consecutive patients (of whom 18 were hospitalized) with severe peripheral arterial disease in 25 legs. The courses of 4 patients are discussed in detail. Significant beneficial effects were documented by subcutaneous PO2 levels, pulse volume measurements, ankle blood pressure measurements, and Doppler ultrasound tracings. Twenty- two of the 25 severe legs benefitted clinically from therapy. Immediate thera peutic effects from the boot are attributed to decreases in venous pressure, in terstitial fluid pressure, vasoconstriction, and viscosity, and to increases in car diac output, pulse pressure, and fibrinolysis in the treated leg. The long-term beneficial effects of boot therapy may be related to improved collateral flow and to the rechanneling of obstructed vessels.
Get full access to this article
View all access options for this article.
References
1.
Dillon, R.S. : The Circulator Boot: An end-diastolic air compression boot that augments the peripheral arterial circulation. J. Clin. Engineering, in press.
2.
Dillon, R.S. : Successful treatment of the ischemic leg in nine patients with the Circulator Boot (CB). Diabetes, 26(Suppl 1): 371, 1977.
3.
Landis, E.M. : The treatment of peripheral vascular disease by means of alternative negative and positive pressure. Pennsylvania Med. J., 38: 579-583, 1953.
4.
Landis, E.M. , Hitzrot, L.H.: The clinical value of alternative suction and pressure in the treatment of advanced peripheral vascular disease. Am. J. Med. Sci., 189: 305-325, 1935.
5.
Landis, E.M. , Gibbon, J.H., Jr.: The effect of alternate suction and pressure on blood flow to the lower extremities. J. Clin. Invest., 12: 925-961, 1933.
6.
Silverglade, A.: Peripheral vascular diseases: Diagnosis and treatment by passive vascular exercises. Arch. Phys. Ther. , 21: 100-110, 1940.
7.
Herrmann, L.G. , Reid, M.R.: Passive vascular exercises: Treatment of peripheral obliterative arterial diseases by rhythmic alteration of environmental pressure. Arch. Surg., 29: 697-704, 1934.
8.
Allen, E.V., Brown, G.E.: Intermittent pressure and suction in the treatment of chronic occlusive arterial disease. JAMA105: 2029-2034, 1935 .
9.
Sanders, C.E. : Cardiovascular and peripheral vascular diseases, treatment by a motorized oscillating bed. JAMA, 106: 916-918, 1936.
10.
Dilts, R.L.: Microcirculation in peripheral arterial ischemic diseases, in The Microcirculation in Clinical Medicine. Edited by R.Wells. New York, Academic Press, 1973, pp. 113-145.
11.
Allwood, M.J. : The effect of an increased local pressure gradient on blood flow in the foot. Clin. Sci., 16: 231-239, 1957.
12.
Loane, R.A. : Effect of rhythmically inflating a pneumatic cuff at the ankle on blood flow in the foot. J. Appl. Physiol. , 14: 411-414, 1959.
13.
Henry, J.P. , Winsor, T.: Compensation of arterial insufficiency by augmenting the circulation with intermittent compression of the limbs. Am. Heart J., 70: 79-88, 1965.
14.
Gaskell, P. , Parrott, J.C.W.: The effect of a mechanical venous pump on the arterial circulation of the feet in the presence of arterial obstruction . Surg. Gynecol. Obstet., 146: 583-592, 1978.
15.
Raines, J.K. , Darling, R.C., Buth, J., et al.: Vascular laboratory criteria for the management of peripheral vascular disease of the lower extremities. Surgery, 79: 21-29, 1976.
16.
Yao, S.T., Hobbs, J.T., Irvine, W.T.: Ankle systolic pressure measurements in arterial diseases affecting the lower extremities. Br. J. Surg., 56: 676-679, 1969.
17.
Lennihan, R. , Jr., Mackereth, M.A.: Ankle pressures in arterial occlusive disease involving the legs. Surg. Clin. North Am., 53: 657-666, 1973.
18.
Johnson, W.C. , Patten, D.H.: Predictability of healing of ischemic leg ulcers by radio-isotopic and Doppler ultrasonic examination. Am. J. Surg., 133: 485-490, 1977.
19.
Yao, S.T., Hobbs, J.T., Irvine, W.T.: Pulse examination by an ultrasonic method. Br. Med. J., 4: 555-557, 1968.
20.
Nicolaides, A.N., Gordon-Smith , I.C., Dayandas, J., et al.: The value of Doppler blood velocity tracings in the detection of aortoiliac disease in patients with intermittent claudication. Surgery, 80: 774-778, 1976.
21.
Montgomery, H., Horwitz, O.: Oxygen tension of tissues by the polarographic method. I. Introduction: Oxygen tension and blood flow of the skin of the human extremities. J. Clin. Invest., 29: 1120-1130, 1950.
22.
Penneys, R. , Montgomery, H.: Oxygen tension of tissues by polarographic method. V. Rate of movement of oxygen from peripheral artery to skin. J. Clin. Invest., 31: 1042-1048, 1952 .
23.
Horwitz, O. , Abramson, D.G.: A modification of the vasodilation test . Am. J. Cardiol., 6: 663-666, 1960.
24.
Mavor, G.E. : The pattern of occlusion in atheroma of the lower limb arteries: The correlation of clinical and arteriographic findings . Br. J. Surg., 43: 352-364, 1956.
25.
Humphries, A.W. : The relation of the natural history of arteriosclerosis to surgical management. in Management of Arterial Occlusive Disease. Edited by W.A. Dale. Chicago: Year Book Medical1971, pp. 67-78.
26.
O'Rourke, D.A. , Hede, J.E.: Reversible leg ischemia due to diuretics . Br. Med. J., 1: 114, 1978.
27.
Knight, M.T.N. : Effect of intermittent compression of arms on deep venous thrombosis in legs. Lancet, 2: 1265-1268, 1976.
28.
Birtwell, W.C. , Clauss, R.H., Dennis, C., et al.: The evolution of counterpulsation techniques. Med. Instr., 10: 217-223, 1976.
29.
Clark, W.B. , Prescott, R.J., MacGregor, A.B., et al.: Pneumatic compression of the calf and postoperative deep-vein thrombosis. Lancet, 2: 5-7, 1974.
30.
Ramirez, G. , O'Neill, W.M., Jr., Lambert , R., et al.: Cholesterol embolization, a complication of angiography. Arch. Intern. Med., 138: 1430-1432, 1978.
Cooperman, M., et al.: Cardiovascular risk factors in patients with peripheral vascular disease. Surgery, 84: 505-509, 1978.
33.
Fitzgerald, D.E., Carr, J.: Peripheral arterial disease: Assessment by arteriography and alternate non-invasive measurements. Am. J. Roentgenol. Radium Ther. Nucl. Med., 128: 385-388, 1977.
34.
Morris, P.E. , Hessel, S.J., Couch, N.P., et al.: Surgery and the progression of the occlusive process in patients with peripheral vascular disease. Radiology, 124: 343-348, 1977.
