Monday, August 4, 2014

Intermittent Pneumatic Foot and Calf Compression: Treatment of Lower Limb Circulation Problems



Is intermittent pneumatic foot and calf compression something new and different in the medical world of today? It  is becoming increasingly common in terms of treating patients with circulation problems of the lower limbs. Impaired blood circulation, particularly with respect to diabetes and heavy smoking has been a serious, medical concern for many years.

Intermittent claudication of the popliteal artery or peripheral vascular disease results in compromised blood flow. Over the years, many patients have suffered the loss of lower limbs because of it. The question becomes what is the best way to improve and maintain circulation of the lower limbs. Note that continual circulation to the lower limbs is vital in terms of a patient’s ability to walk and maintain general mobility. 

From an historical perspective, “the concept of alternating external limb compression for ameliorating rest pain in patients with critical limb ischemia was introduced in the mid-1930s”.

Research has continued and “in the late 1970s, the delivery of pneumatic compression to the foot and ankle was reported to enhance perfusion in the skin and muscle of the leg…”

More recently, “intermittent pneumatic compression (IPC) of the foot was found to significantly improve the walking ability of patients with stable intermittent arterial claudication and to increase their pressure indices…”

How does high-level pneumatic compression work?

High-level pneumatic compression (120 mm Hg) of the foot empties the plantar venous plexus and reduces the venous leg pressure, increasing the arteriovenous pressure gradient. A significant enhancement of the arterial calf inflow ensues…”

In other words, the circulation to legs and feet improves with intermittent pneumatic foot and calf compression when used as a method of treatment on a regular basis.


“The effect of exercise compared with placebo or usual care was inconclusive on mortality, amputation and peak exercise calf blood flow due to limited data. Evidence was generally limited for exercise compared with surgical intervention, angioplasty, antiplatelet therapy, pentoxifylline, iloprost and pneumatic foot and calf compression due to small numbers of trials and participants. Angioplasty may produce greater improvements than exercise in the short term but this effect may not be sustained.”

Alternative treatments are available but difficult to prove. For example, “Ginkgo biloba is a vasoactive agent and is used to treat intermittent claudication.”

Research continues with the expectations of more positive results for intermittent pneumatic foot and calf compression. 

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