van Bemmelen P, Char D, Giron F, Ricotta JJ.
Angiographic improvement after rapid intermittent compression
treatment [ArtAssist] for small vessel obstruction.
Ann Vasc Surg. 2003 Mar;17(2):224-8. Epub 2003 Mar 06.

Department of Surgery, State University of New York at Stony Brook,
Stony Brook, NY, USA.
A case is presented of a female ex-smoker who underwent bypass or
exploration of all three below-knee arteries with failed results.
Three separate arteriograms, performed at other academic
institutions, demonstrated progressive, severe involvement of the
pedal arteries. Therefore, the patient was prepared to undergo
below-knee amputation surgery for uncontrollable rest pain and
progressive necrosis of the forefoot; instead, the patient
underwent 4 months of intermittent compression treatment. A
fourth arteriogram, performed after 4 months of intermittent
compression treatment (using rapid inflation/deflation and high-
pressure cycle; ArtAssist demonstrated marked improvement of
the posterior tibial artery runoff and development of more
extensive collateral arteries in the calf. The patient's rest pain
subsided and successful limb salvage was accomplished with a
modified transmetatarsal amputation. This case could encourage
other practitioners to repeat arteriography after compression
treatments, which may redirect the treatment plan for selected
patients with critical limb ischemia and nonreconstructable
peripheral vascular disease.