ArtAssist® is the only external pneumatic compression device developed with vascular surgeons for the sole purpose of increasing arterial blood flow. It applies a unique form of pneumatic compression to the foot, ankle and calf. Patients with ischemic disease of the lower limbs who are not good surgical candidates, including diabetic foot ulcers, intermittent claudication or rest pain, have seen positive results with this new technology.
ArtAssist® significantly increases patients' blood flow in the popliteal artery and at the tissue level. Improvements were observed in calf blood flow using duplex imaging and laser Doppler. Further, it has been shown that calf and foot compression increases volumetric blood flow by better than three times that of foot only compression as measured by duplex ultrasonography.
There are at least two mechanisms by which ArtAssist® improves blood flow. First, the foot, ankle and calf veins are almost completely emptied in the sitting patient by using high pressures. By compressing all the tissues below the knee, a large volume of venous blood is emptied with venous pressure dropping close to zero. The increased arterial-venous gradient results in greater arterial inflow.
The increased pressure gradient alone does not account for the large blood flow increases seen with ArtAssist®. A second mechanism for action involves the endothelium. This structure is recently seen as playing an important role in controlling peripheral resistance. Endothelial cells are known to release substances, including nitric oxide and Tissue Factor Pathway Inhibitor that act as vasodilators and anticoagulants. These substances are released in amounts corresponding to the shear rate of blood moving along the vessel's endothelial surface. The very rapid increase and decrease of ArtAssist's compression creates high shear rates intended to stimulate endothelial release of these important biochemical factors and possibly stimulates collateral formation. ArtAssist® increases popliteal artery blood flow by 3.1 times using duplex ultrasonic imaging.
The images below show pre-compression and post-compression velocities on a patient with Fem-pop disease.