Delis KT, Labropoulos N, Nicolaides AN, Glenville B, Stansby G.
Effect of intermittent pneumatic foot compression on popliteal artery
Eur J Vasc Endovasc Surg 2000 Mar ;19(3):270-7

Irvine Laboratory for Cardiovascular Investigation and Research, Academic
Vascular Surgery, London, Paddington, UK.

PURPOSE: the aim was to investigate the effect of intermittent pneumatic foot
compression (IPC(foot)) on popliteal artery haemodynamics in normal individuals
and in patients with intermittent claudication due to peripheral vascular disease
(PVD) (Fontaine stage II). MATERIAL AND METHODS: popliteal artery volume flow
[vFl], pulsatility index [PI], mean velocity [mV], peak systolic [PSV] and end
diastolic velocity [EDV], in 25 limbs of 20 normal subjects and 40 limbs of 32
stable claudicants were obtained in the sitting position before, during and
within 30 seconds after the application of IPC(foot)(applied pressure: 120 mmHg;
inflation time: 3 seconds; deflation time: 17 seconds) using colour-flow duplex
imaging (CFDI). The reproducibility of flow velocity estimations using CFDI in
the horizontal [hor] (recovery) and sitting [sit] positions was evaluated in 20
limbs of normal controls and 20 limbs of claudicants. RESULTS: popliteal artery
vFl, mV, PSV and PI measurements were performed with a coefficient of variation
(CV) of less than 14.6% among claudicants and of less than 13.3% in normal
subjects. EDV is the least reproducible parameter with an overall CV range of
10.2-21.5% in normal controls and 9.1-18.6% in arteriopaths. On application of
IPC(foot)popliteal artery vFl increased by 111% in the control group (p<0.001)
and by 51% in the claudicants (p<0.001). Within 30 seconds of the cessation of
pump action flow decreased significantly in both groups (p<0.001), but maintained
a significantly higher level than that at baseline (p<0. 001, in both groups).
The mV, PSV and EDV showed a similar pattern of significant changes. Both in
normals and claudicants, the PI decreased with IPC(foot)(p<0.001) and increased
post-compression; however, it was significantly lower than baseline (p<0.005)
within 30 seconds of impulse delivery. CONCLUSIONS: current CFDI technology
enables a reproducible estimation of popliteal artery flow velocities.
IPC(foot)can significantly augment arterial calf inflow on an acute basis both in
normals and claudicants. The increase of EDV and decrease of PI indicate that
attenuation of peripheral resistance to flow is the main mechanism underlying the
popliteal artery vFl enhancement on application of IPC(foot). Prospective trials
on the long-term effect of IPC(foot)in the management of patients with PVD are
indicated from the results of this study. Copyright 2000 Harcourt Publishers Ltd.