van Bemmelen PS, Mattos MA, Faught WE, Mansour MA,
Barkmeier LD, Hodgson KJ, Ramsey DE, Sumner DS.
Augmentation of blood flow in limbs with occlusive arterial disease by
intermittent calf compression.
J Vasc 1994 Jun;19(6):1052-8

Department of Surgery, Southern Illinois University School of Medicine, Springfield 62794-9230.

PURPOSE: This study was designed to investigate the effect of intermittent calf
compression on popliteal arterial blood flow and to see how flow is influenced by
position of the subject and by arterial blood pressure at the ankle. METHODS:
Volume flow in the popliteal artery of subjects in the sitting and prone
positions was measured with duplex ultrasonography before inflation and
immediately after deflation of a pneumatic cuff placed around the calf. Eleven
legs of control subjects and 41 legs of patients with symptoms (32% patients with
diabetes) with decreased ankle pressure were studied. Cuffs were inflated for 2
seconds at pressures ranging from 20 to 120 mm Hg. RESULTS: An increase in
arterial blood flow of two to eight times (mean 4.4 +/- 2.0) was found on
deflation of the cuff in seated control subjects. Little change in flow was
observed when the subjects were in the prone position. In seated patients with
arterial obstruction, the mean increase in arterial flow was 3.2 +/- 1.6 times
the resting flow. Little correlation was found between the maximum increase in
flow and the ankle/brachial index. CONCLUSIONS: An increased arteriovenous
pressure gradient accounts for some but not all of the flow increase, much of
which must be attributable to transient vasodilatation. Because the increase in
flow does not depend on an increased inflow pressure and was not adversely
affected by a low resting ankle-brachial pressure index or a low toe-pressure,
intermittent external limb compression may deserve investigation as a possible
adjunct to the nonoperative treatment of patients with severe arterial
insufficiency.