Pneumatic compression device shows promise in lower extremity arterial disease

Use of an intermittent pneumatic compression device as an adjunct treatment helps improve quality of life and walking endurance in patients with lower extremity arterial disease (LEAD), as shown in the results of a pilot study presented at the Asian Pacific Society of Cardiology (APSC) Congress 2019.

“Although the results are promising, increased referral to the vascular laboratory and rate of patient dropout should be considered for implementation of a full-scale study to improve chances of a clear outcome,” the investigators said.

In the study, the investigators recruited 12 adult patients with LEAD. They assessed quality of life and walking endurance using the VascuQOL questionnaire and the 6-minute walk test, respectively, at baseline and after 12, 24 and 36 sessions of treatment.

Only six patients completed 12 sessions of treatment, and none were evaluated after 24 or 36 sessions. Two patients had claudication at baseline with an initial distance of 220 and 69 metres. Claudication disappeared after completion of 12 treatment sessions. [APSC 2019, Igualada VO, et al]

Mean post-treatment scores for the outcomes investigated notably improved compared with pretreatment scores. Walking endurance increased after 12 sessions, from 182 metres to 208 metres. Likewise, scores in all VascuQOL domains (social, emotion, pain, symptom and activity) increased after treatment completion.

“However, due to a small sample size, the number of patients is not enough to form a normal distribution for the data. Therefore, it is not possible to calculate an accurate p-value,” the investigators pointed out.

Treatment was delivered using an arterial assist device, which consists of a pump and soft cuffs, designed to noninvasively increase blood flow by applying a unique compression sequence of 120 mm Hg to the foot, ankle and calf.

According to the developers, the device increases blood circulation by threefold during use and opens collateral arteries in a process called arteriogenesis. Recommended use is 3 hours daily, and users may expect positive results within the first month of therapy (ie, rest pain relief, pain-free walking distance increase and wound healing).

“This study addresses the absence of published data regarding unkown and unquantified benefits of intermittent pneumatic compression device as an adjunct [treatment] for LEAD,” the investigators said.

They indicated that the device may be better evaluated in future studies with an adequate sample size and a system for improving referrals to the vascular laboratory for patients that may benefit from intermittent pneumatic compression, better communication between the staff and investigators, and a validated questionnaire using the patients language or dialect to help with the study’s conduct.