Labropoulos N, Watson WC, Mansour MA, Kang SS, Littooy FN, Baker WH.
Acute effects of intermittent pneumatic compression on popliteal artery blood
Arch Surg 1998 Oct;133(10):1072-5

Department of Surgery, Loyola University Medical Center, Maywood, Ill 60153, USA.

OBJECTIVES: To investigate the immediate effects of intermittent pneumatic foot
and calf compression (IPFCC) on popliteal artery blood flow in symptom-free
volunteers and to determine the reproducibility of color flow duplex imaging in
the popliteal artery. DESIGN: Cohort study. SETTING: A university associated
tertiary care hospital. PATIENTS: Forty lower limbs of 30 volunteers without
symptoms or noteworthy risk factors of peripheral vascular disease.
INTERVENTIONS: Popliteal artery blood flow was measured in the sitting position
before, during, and after the application of IPFCC using color flow duplex
imaging. The interobserver, intraobserver, and between occasion within-subject
variability of the popliteal artery blood flow were evaluated in 5 symptom-free
volunteers who had at least 5 color flow duplex imaging measurements taken at
each of the above time points on 3 different days. MAIN OUTCOME MEASURES: The
arterial diameter, peak systolic, end diastolic, and reverse-flow velocities were
measured, as well as the duration of forward flow during diastole before, during,
and after IPFCC. The same variables were measured in 5 separate volunteers by 3
different observers, on 3 separate days, at 3 separate times to determine
reproducibility. RESULTS: Including all types of variability, the popliteal
artery blood flow varied from 8% to 39% with a mean value of 19%. Since the
diameter of the artery was obtained with less than 5% variability, the time
average mean velocity was responsible for the high variation in flow. During
application of the IPFCC, the popliteal artery blood flow increased significantly
in all subjects (P<.001). The mean increase in the flow was 2.4 times the
baseline values. The diameter of the arteries remained unchanged while the time
average velocity increased significantly (P<.001). This velocity increase was due
to marked elevation in the peak systolic and end diastolic velocities and
diminution of the reverse-flow component, as well as a prolongation of the
forward flow during diastole. After cessation of the pump, flow returned to
baseline levels (P=.41) CONCLUSIONS: Ultrasound-derived popliteal artery blood
flow measurements show moderate variability. The application of IPFCC greatly
enhances popliteal artery blood flow. The flow increase is due to a dramatic drop
in the peripheral vascular resistance as the peak systolic and end diastolic flow
velocities increase and the reverse-flow component diminishes. Its role in the
treatment of lower extremity occlusive arterial disease needs to be determined.