This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Haemodynamic effect of intermittent pneumatic compression of the leg after infrainguinal arterial bypass grafting. BJS 2004; 91: 429-434.
Published: 27th February 2004
Authors: K. T. Delis, M. J. Husmann, G. Szendro, N. S. Peters, J. H. N. Wolfe, A. O. Mansfield et al.
Background
Intermittent pneumatic compression (IPC) may increase blood flow through infrainguinal arterial grafts, and has potential clinical application as blood flow velocity attenuation often precedes graft failure. The present study examined the immediate effects of IPC applied to the foot (IPCfoot), the calf (IPCcalf) and to both simultaneously (IPCfoot+calf) on the haemodynamics of infrainguinal bypass grafts.
Method
Eighteen femoropopliteal and 18 femorodistal autologous vein grafts were studied; all had a resting ankle : brachial pressure index of 0·9 or more. Clinical examination, graft surveillance and measurement of graft haemodynamics were conducted at rest and within 5 s of IPC in each mode using duplex imaging. Outcome measures included peak systolic (PSV), mean (MV) and end diastolic (EDV) velocities, pulsatility index (PI) and volume flow in the graft.
Results
All IPC modes significantly enhanced MV, PSV, EDV and volume flow in both graft types; IPCfoot+calf was the most effective. IPCfoot+calf enhanced median volume flow, MV and PSV in femoropopliteal grafts by 182, 236 and 49 per cent, respectively, and attenuated PI by 61 per cent. Enhancement in femorodistal grafts was 273, 179 and 53 per cent respectively, and PI attenuation was 63 per cent.
Conclusion
IPC was effective in improving infrainguinal graft flow velocity, probably by reducing peripheral resistance. IPC has the potential to reduce the risk of bypass graft thrombosis. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Full text