Effect of therapy with the pneumatic end-diastolic leg compression boot on peripheral vascular tests and on the clinical course of peripheral vascular disease.

The Circulator Boot is a new end-diastolic pneumatic leg compression device. This report describes its effect on 6 normal young people, 8 ambulatory patients with mild peripheral arterial disease, and 21 consecutive patients (of whom 18 were hospitalized) with severe peripheral arterial disease in 25 legs. The courses of 4 patients are discussed in detail. Significant beneficial effects were documented by subcutaneous PO2 levels, pulse volume measurements, ankle blood pressure measurements, and Doppler ultrasound tracings. Twenty-two of the 25 severe legs benefitted clinically from therapy. Immediate therapeutic effects from the boot are attributed to decreases in venous pressure, interstitial fluid pressure, vasoconstriction, and viscosity, and to increases in cardiac output, pulse pressure, and fibrinolysis in the treated leg. The long-term beneficial effects of boot therapy may be related to improved collateral flow and to the rechanneling of obstructed vessels.