![]() ![]() It may be presumed that in these studies rapid 0.6 sec inflation of chambers a strike transfer of force generated venous-arteriolar reflex (VAR) with subsequent stop to arterial inflow and vein filling. It was reported that using rapid IPC with pressures of around 100 mmHg tripled popliteal artery flow, demonstrating significant decrease in peripheral arterial resistance caused by reduction of venous pressure. The concluding remarks were that “IPC foot-calf is the most effective in emptying the leg veins”. The applied device pressures were set below arterial pressure so that arterial pressures remained unaffected. ![]() The increased arterial-venous pressure gradient results in a greater arterial flow. Until recently the generally accepted notion was that by compressing all the tissues below the knee by an inflated cuff, a large volume of venous blood is emptied with venous pressure dropping to nearly zero. These include emptying of the plantar venous plexus, reduction of the venous leg pressure, increase of the arterio-venous pressure gradients in dependent patients, increase of arterial flow, release of vasodilators (nitric oxide, prostacyclins), reduction of local vascular resistance, induction of post occlusive hyperemia and transient suspension of the arteriolar-venous reflex. There are several mechanisms by which a positive effect on the lower limb tissue perfusion is conferred by the use of IPC. Attempts to support the inflow of arterial blood to ischemic limb regions by means of pneumatic pumps and sleeves have a long tradition. Despite of IPC technology having been available in its present form for many years uncertainty remains about its mechanism to improve arterial inflow and clinical effectiveness in a population who are in urgent need of effective treatment options. There is no objective data, except hypotheses from the academic centers, documenting the mechanism of increasing the arterial flow and increasing the knowledge of the beneficial effects. The only treatment here is increasing blood peripheral tissue flow with the help of external support by intermittent pneumatic compression devices (IPC). There is a large group of patients with ischemia of the lower leg and foot without effect of the pharmacological treatment who are not eligible for surgical reconstruction of the arteries due multi-segmental arterial obstruction and general contraindications for major surgery. Pharmacological treatment, especially with statins, limited the indications for surgical treatment, created a challenge for more effective conservative treatment. Ischemia of lower limbs due to atherosclerosis of arteries causing intermittent claudication, and in cases of more advanced state necrotic changes of peripheral tissues, concerns in the age group above 60 years between 1% and 7% of the population. ![]()
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