Number 8
THE CONTRIBUTIONS OF ARTERIAL AND VENOUS
VOLUMES TO INCREASED CUTANEOUS BLOOD FLOW
DURING LEG COMPRESSION
A.R. Eze, MD, P.L. Cisek, MD, B.S. Holland, PhD, A.J. Comerota Jr., R. Verramasuneni, BS, and A.J. Comerota, MD, FACS. Department of Surgery, Temple University School of Medicine, Philadelphia, PA
Ann of Vasc Surg 1998; 12:182-186
Intermittent lower extremity compression produces increased cutaneous blood flow in limbs with normal vasculature and limbs with superficial femoral artery occlusion. The source of this increased perfusion has not been elucidated. The purpose of this study is to determine the relative contributions of augmented arterial inflow (AI) and retrograde venous displacement (V) to cutaneous blood flow during foot and leg compression in limbs with normal vasculature, and to evaluate whether physical activity influenced the response to compression.
Fifty limbs of both sedentary and active normal volunteers were studied. An Inflatable foot and calf compression cuff attached to a timed-pressure pump (ArtAssist® Model AA1000, ACI Medical, Inc., San Marcos, CA, USA) was applied to the subjects' legs. Skin perfusion at the great toe was recorded by a laser Doppler probe (Laserflo Model BPM 403, TSI Inc., St. Paul, MN, USA). Total skin perfusion (A) with compression was calculated as the average over four compression cycles. A thigh tourniquet is inflated to 220 mmHg to obliterate arterial inflow while keeping the veins full and perfusion is again measured (B). Finally, perfusion (C) is measured after the leg is exsanguinated from elevation and a rubber bandage tightly wrapped around the leg with the thigh tourniquet again inflated.
The percentage of venous component (V) of perfusion was calculated as:
V = [(B-C)/A] x 100%
The percentage of augmented arterial inflow (AI) is calculated as:
AI = (A-V) x 100%
Subjects in the sedentary group had 93% of their augmented flow from the arterial side with a 7% venous component. The active group had augmented arterial inflow of 86% and a 14% venous component. The differences in the mean skin perfusion and the percent venous component between the two groups were significant (p<0.01 and p<0.05 respectively).
ArtAssist®, VenAssist®, VenaPulse®, and APG® are register trademarks of ACI Medical, LLC, San Marcos, CA, USA.
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Number 8
THE CONTRIBUTIONS OF ARTERIAL AND VENOUS
VOLUMES TO INCREASED CUTANEOUS BLOOD FLOW
DURING LEG COMPRESSION
A.R. Eze, MD, P.L. Cisek, MD, B.S. Holland, PhD, A.J. Comerota Jr., R. Verramasuneni, BS, and A.J. Comerota, MD, FACS. Department of Surgery, Temple University School of Medicine, Philadelphia, PA
Ann of Vasc Surg 1998; 12:182-186
Intermittent lower extremity compression produces increased cutaneous blood flow in limbs with normal vasculature and limbs with superficial femoral artery occlusion. The source of this increased perfusion has not been elucidated. The purpose of this study is to determine the relative contributions of augmented arterial inflow (AI) and retrograde venous displacement (V) to cutaneous blood flow during foot and leg compression in limbs with normal vasculature, and to evaluate whether physical activity influenced the response to compression.
Fifty limbs of both sedentary and active normal volunteers were studied. An Inflatable foot and calf compression cuff attached to a timed-pressure pump (ArtAssist® Model AA1000, ACI Medical, Inc., San Marcos, CA, USA) was applied to the subjects' legs. Skin perfusion at the great toe was recorded by a laser Doppler probe (Laserflo Model BPM 403, TSI Inc., St. Paul, MN, USA). Total skin perfusion (A) with compression was calculated as the average over four compression cycles. A thigh tourniquet is inflated to 220 mmHg to obliterate arterial inflow while keeping the veins full and perfusion is again measured (B). Finally, perfusion (C) is measured after the leg is exsanguinated from elevation and a rubber bandage tightly wrapped around the leg with the thigh tourniquet again inflated.
The percentage of venous component (V) of perfusion was calculated as:
V = [(B-C)/A] x 100%
The percentage of augmented arterial inflow (AI) is calculated as:
AI = (A-V) x 100%
Subjects in the sedentary group had 93% of their augmented flow from the arterial side with a 7% venous component. The active group had augmented arterial inflow of 86% and a 14% venous component. The differences in the mean skin perfusion and the percent venous component between the two groups were significant (p<0.01 and p<0.05 respectively).