Document Detail


Haemodynamic effect of intermittent pneumatic compression of the leg after infrainguinal arterial bypass grafting.
MedLine Citation:
PMID:  15048742     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 (IPC(foot)), the calf (IPC(calf)) and to both simultaneously (IPC(foot+calf)) on the haemodynamics of infrainguinal bypass grafts. METHODS: 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; IPC(foot+calf) was the most effective. IPC(foot+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.
Authors:
K T Delis; M J Husmann; G Szendro; N S Peters; J H N Wolfe; A O Mansfield
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The British journal of surgery     Volume:  91     ISSN:  0007-1323     ISO Abbreviation:  Br J Surg     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-03-29     Completed Date:  2004-05-10     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  429-34     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2004 British Journal of Surgery Society Ltd.
Affiliation:
Regional Vascular Surgery Unit, St Mary's Hospital, Imperial College School of Medicine, London, UK. k.delis@ic.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Flow Velocity / physiology
Blood Vessel Prosthesis*
Constriction
Cross-Over Studies
Diastole
Female
Foot
Graft Occlusion, Vascular / prevention & control
Humans
Leg / blood supply*
Male
Physical Therapy Modalities*
Systole
Vascular Resistance / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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