Killewich LA, Sandager GP, Nguyen AH, Lilly MP, Flinn WR.
Venous hemodynamics during impulse foot pumping.
J Vasc Surg 1995 Nov ;22(5):598-605

Department of Surgery, University of Maryland Medical Systems, Baltimore 21201, USA.

PURPOSE: This study was designed to measure the effect of intermittent pneumatic
compression of the plantar venous plexus on popliteal vein (PV) and common
femoral vein (CFV) velocities measured by duplex ultrasound scanning. METHODS:
Thirty lower limbs in 15 healthy volunteers had venous duplex scanning
measurement of PV and CFV velocities before and during foot pumping with an
arteriovenous impulse foot pump system. Venous velocities were measured at two
pump pressure settings (100 mm Hg, 200 mm Hg) and during two pump impulse
durations (short = 1 second, normal = 3 seconds). All limbs were examined with
the subjects in the supine position, and then measurements were repeated with
subjects in the 15-degree reverse Trendelenburg position. The mean maximum venous
velocity (MVV) produced by foot pumping was compared with resting venous velocity
at each anatomic location and for each technologic variable. RESULTS: Impulse
foot pumping produced a statistically significant increase in MVV in both the PV
and the CFV compared with resting velocities. This significant increase was
observed for both pressure settings and both impulse durations, and no
differences produced by these two individual variables could be detected. The
increase in MVV produced by foot pumping was similar for limbs in the supine
position and those examined in the reverse Trendelenburg position. The percentage
increase in MVV produced by foot pumping was significantly higher in the PV than
in the CFV. CONCLUSIONS: Intermittent pneumatic compression of the plantar venous
plexus produces measurable increases in venous outflow from the lower limbs of
normal subjects. This study seems to justify further evaluation of the
effectiveness of this technique for mechanical deep venous thrombosis prophylaxis
in selected high-risk patient groups.