Miranda F Jr, Perez MC, Castiglioni ML, Juliano Y, Amorim JE,
Nakano LC, de Barros N Jr, Lustre WG, Burihan E.
Effect of sequential intermittent pneumatic compression on both leg lymphedema
volume and on lymph transport as semi-quantitatively evaluated by
Lymphology 2001 Sep;34(3):135-41

Vascular Surgery Division, Federal University of Sao Paulo, Paulista School of
Medicine, SP, Brazil. fmirandajr.dcir@epm.br

Sequential Intermittent Pneumatic Compression (SIPC) is an accepted method for
treatment of peripheral lymphedema. This prospective study evaluated the effect
in 11 patients of a single session of SIPC on both lymphedema volume of the leg
and isotope lymphography (99Tc dextran) before SIPC (control) and 48 hours later
after a 3 hour session of SIPC. Qualitative analysis of the 2 lymphoscintigrams
(LS) was done by image interpretation by 3 physicians on a blind study protocol.
The LS protocol attributed an index score based on the following variables:
appearance, density and number of lymphatics, dermal backflow and collateral
lymphatics in leg and thigh, visualization and intensity of popliteal and
inguinal lymph nodes. Volume of the leg edema was evaluated by measuring limb
circumference before and after SIPC at 6 designated sites. Whereas there was a
significant reduction of circumference in the leg after SIPC (p<0.05), there was
no significant difference in the index scores of the LS before and after
treatment. This acute or single session SIPC suggests that compression increased
transport of lymph fluid (i.e., water) without comparable transport of
macromolecules (i.e., protein). Alternatively, SIPC reduced lymphedema by
decreasing blood capillary filtration (lymph formation) rather than by
accelerating lymph return thereby restoring the balance in lymph kinetics
responsible for edema in the first place.