An intermittent claudication meta-analysis: Findings point to sustained improvements after home use device treatment

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Temple University’s systematic review and meta-analysis on eight independent intermittent claudication studies using pneumatic compression pumps has shown significant improvements in walking distances even after treatment was withdrawn. Paul van Bemmelen, of Temple University, Philadelphia, USA, conducted the meta-analysis. The study was published in the Journal of Vascular Surgery, in February 2018.

The objective of the study was to conduct a systematic review and meta-analysis of randomised controlled trials evaluating the efficacy of a unique form of high-pressure intermittent limb compression (HPILC) in improving walking distance in patients with intermittent claudication. It is estimated that currently >1 million adults in the USA have claudication. HPILC significantly increases flow rate in the popliteal artery by decreasing venous pressure as well as by promoting the release of angiogenic growth factors and nitric oxide, a potent vasodilator. These physiologic effects are postulated to improve symptoms in patients with claudication.

The ArtAssist device

A search through December 31, 2016, was performed to identify all randomised controlled trials evaluating the efficacy of HPILC for the management of intermittent claudication. The primary outcome measured was absolute claudication distance (ACD).  Eight studies eligible for inclusion were identified. These studies had a combined total of 290 subjects, 172 of whom were randomised to HPILC. An increase in ACD was observed in subjects treated with HPILC in all studies. The overall change in mean ACD ranged from 53m to 275m for subjects receiving compression compared with 5m to 15m for controls.

“HPILC is associated with a significant increase in ACD compared with controls. Limb compression is now seen as an effective, non-invasive treatment option for patients with intermittent claudication. Multiple studies have confirmed that pneumatic compression is an effective means of treating intermittent claudication, but there was a need for cohesion,” said van Bemmelen. “Most of the studies we looked at for this meta-analysis showed vascular improvements lasting months, even years after compression treatment was withdrawn. The reason improvements were sustained can be attributed to collateral arteries that grew as a result of the unique pressure pulses applied by the pneumatic compression device.”

Intermittent claudication is a common manifestation of lower extremity peripheral arterial disease. Patients with claudication have leg pain with ambulation that significantly affects their physical and emotional well-being.

ACI Medical president and head of product development Ed Arkans says, “Meta-analyses are an excellent way to step back and measure our progress, but more importantly, they act as a guide for gaps we can fill to meet the needs of more patients suffering from intermittent claudication. We are very pleased to see the results of the meta-analysis demonstrate that ILC should be considered a valuable treatment modality for lifestyle-limiting claudication.”

The ArtAssist device is a specially designed, patented, non-invasive pneumatic device for the treatment of peripheral artery disease. Clinical evidence has shown that its use doubles and triples walking distances and has long-term benefits. The device is available throughout North America for patients who use it on a temporary basis with a physician’s prescription.

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