Introduction | For Patients & Caretakers | For Physicians | For DME Dealers | What Does “ACI” Stand For?
ArtAssist FAQ Introduction
How does it work?
ArtAssist®…The Arterial Assist Device® increases arterial blood flow in patients with peripheral arterial disease (PAD), a condition that causes poor circulation in the lower limbs. It applies rapid, high pressure compression to the foot, ankle & calf.
This arterial pump system works similarly to the calf muscle pump: when a person walks briskly, the calf muscle pump acts as a second heart in the lower legs. It not only empties the venous blood, but it also allows the arterial blood to flow further down towards the toes. Since patients suffering from intermittent claudication (walking pain) or rest pain cannot walk for long periods, they are not using their calf muscle pump function and therefore, the blood is stagnant. This is also common in cases with arterial ulcers, where walking is limited due to pain or tissue trauma. Without a sufficient supply of oxygen-rich blood, tissue below the blockage may die (ulceration & gangrene).
The ArtAssist® device simulates the calf muscle pump by creating circulation. When the foot and ankle are compressed, the veins of the foot are almost completely emptied, which preloads the calf. One second later, the calf is compressed and the veins of the calf are emptied. After 3 seconds, the compression is released, allowing the arterial blood to refill the veins. After 17 seconds of rest, the ArtAssist® device repeats the sequence.
Patient with problems associated with poor arterial circulation in the lower limbs can benefit from this device:
- Non-surgical candidates (those who cannot have surgery)
- Failed bypass surgery
- Diabetic or non-diabetic arterial ulcers
- Intermittent claudication (blockage in the artery resulting in pain during exercise and relief at rest)
- Rest pain (severe blockage in the artery resulting in consistent pain – tissue may break down into an ulcer)
Not recommended for:
- During episodes of superficial phlebitis, cellulitis or osteomyelitis (uncontrolled infection/inflammation)
- When increased venous and lymphatic return is undesirable, such as patients with severe congestive heart failure
- When deep vein thrombosis (DVT) or pulmonary embolism exists or is suspected
- Rapidly deteriorating disease/acute ischemia due to arterial blood clots
For Patients & Caretakers
How do I get an ArtAssist® device?
There are just four easy steps to obtaining the ArtAssist® device for home use:
- The patient completes and signs the Rental Agreement. You can request one by calling toll free 888-453-4356, emailing us at firstname.lastname@example.org or simply downloading & printing the PDF document here.
- The doctor needs to fill out a prescription form for the ArtAssist® device, but s/he can also use his/her own prescription pad.
(Recommended regimen: 1 hour T.I.D. for 90 days)
- Send ACI Medical the completed Rental Agreement and doctor’s prescription via email or fax (760-744-4401).
- Call ACI Medical toll free to schedule delivery of the device.
When we receive an order, we work fast to send you your pump because we understand that many patients cannot wait long for therapy. ACI Medical processes and ships orders on the same day or by the next business day. Pumps usually arrive at the patient’s home or facility in about 4 business days. When the pumps arrive, our customer service department calls to make sure everything is in order and that patients can get started with therapy as soon as possible.
Does a representative come to my house to show me how to use the ArtAssist® device?
ACI Medical currently has an ArtAssist® device expert in the western United States and one in the midwest. If you would like personal assistance, please give ACI Medical a call (toll free 888-453-4356) to schedule an appointment or contact them directly:
Dana Lockrey, National Account Executive, Western US: email@example.com
Barb Gentilli, Vascular Specialist, Midwestern US: firstname.lastname@example.org
How much does an ArtAssist® device pump system cost?
Please note: As of January 1, 2013 the ArtAssist® device may be subject to the 2.3% Medical Device Excise Tax under the Affordable Care Act.
Pumps are typically rented, but they can also be purchased. Here are the options:
Three-month Rental Plan: $1200/90 days
We recommend renting the ArtAssist® device on this plan because it takes at least three months for collateral bypass arteries to naturally form in your limbs as a result of pump therapy. Patients can, of course, rent for additional months at $400 each month if they need more therapy. Though you do not need another prescription from your doctor, we recommend that you keep lines of communication open. Your doctor knows what you need. Add tax for CA residents.
Month-to month Rental Plan: $650-$750/1st month, $480 additional
Some patients prefer to rent on a month-to-month basis. If a doctor has prescribed therapy for one leg, patients can rent the device for $650 the first month, then $480 thereafter. If a doctor has prescribed therapy for both legs, patients can rent the device for $750 the first month, then $480 thereafter. Add tax for CA residents.
The purchase price is $4800 for a unilateral (one-leg) system and $4900 for a bilateral (two-leg) system, plus tax (CA only) and shipping.
Renting to Purchase
If you are renting to own, fifty percent of all rental costs will be contributed to the purchase price.
A component of my ArtAssist® device system needs replacing/repair. What do I do?
If there is an issue with your system (cuffs, tubing, controller, etc.) that prevents you from getting the full benefits of therapy, do not hesitate to call ACI Medical for a replacement!
A patient can use the cuff many times before it must be replaced. For patients under a rental plan, replacement cuffs are free of charge. However, purchasers are charged $170 per cuff plus shipping.
For rental patients, replacement tubing is free of charge. Purchasers are charged $100 for each tubing set plus shipping.
Does Medicare/Medicaid, supplemental or private insurance reimburse?
At this time, Medicare as a whole does not guarantee reimbursement for the ArtAssist® device. ACI Medical does not work directly with private or supplemental insurances because there is no guarantee they will pay for it. Instead, we go through separate billing companies. Nonetheless, we at ACI will assist you in any way we can to get you the therapy you need as quickly as possible. Our HCPCS code is E0675. Don’t hesitate to call us! (888) 453-4356
Are there different cuff sizes?
ArtAssist® device compression cuffs are shipped with the standard “one size fits all” cuff. They can be altered to fit different leg sizes by adjusting the straps.
However, ACI Medical does carry a smaller-sized cuff. If the standard size cuff is too big, you may request a smaller one by calling us.
If you have a unique condition, don’t let it prevent you from the therapy you need. Give us a call and we will do our best to find you a solution. 888-453-4356
I have an upper extremity disease or an amputation. Does ACI Medical make cuffs that will fit?
Yes, we do! Visit our Ordering Page under the Specialized Inflation Cuffs section to see how we can accommodate patients with upper extremity PAD or an existing amputation.
As always, if you have questions, give us a call! 888-453-4356
Can the compression cuffs be washed?
Yes, the ArtAssist® device compression cuffs can be washed. We have special washing instructions and special caps to block water from getting into the cuff’s air bladders. Please call us if you need assistance: 888-453-4356
Does this compression therapy hurt?
No, ArtAssist® device compression therapy should not cause pain. In fact, patients with rest pain have stated that their rest pain is relieved after using the pump.
However, if you have a painful ulcer on the foot area and experience discomfort upon foot compression, we can send you special caps to apply to the foot tubing so that you may temporarily use only the calf compression. You will still have beneficial results and, after a while, foot compression should be tolerable.
Clinical studies show a 100% increase in blood flow using only foot compression, a 190% increase in calf-only compression, and a 270% increase when both the foot and calf are compressed.
Is the ArtAssist® device user-friendly?
Yes! Since it was designed to be used at home, there is no need for a clinician to operate the pump. Additionally, an instructional DVD comes with every pump system, demonstrating step-by-step how to use it. Patients can also call our toll free number (888) 453-4356 for any assistance between the hours of 9 a.m. – 6 p.m Pacific Standard Time.
The seated patient only needs to turn on one switch to operate the pump – all timing and pressures are preset – and the pump alarms after therapy is completed. The recommended usage time is three hours per day, broken up into one-hour sessions (once in the morning, once in the afternoon and once in the evening).
Will I need the ArtAssist® device for the rest of my life?
For most patients, ArtAssist® device therapy is only needed for 3 to 6 months, the typical time it takes to build permanent collateral arteries around the blockage. Once a patient’s ulcer has healed, or once they can walk pain-free, they must be committed to a walking/exercise program to keep their collateral arteries open. If there is no way a patient can commit to such a program, they may need to purchase the pump.
How long does it take to see results?
Although the average rental period is 3 to 6 months, patients should be able to see beneficial results within the first few weeks.
Some positive signs are:
- Warmth in the foot area, where it was previously cold to the touch
- In cases of ulcers, the tissue should look pink or have blood on the bandages
- In cases of intermittent claudication (walking pain), patients should be able to walk farther without pain
- In cases of rest pain, pain should be alleviated during and after pump therapy
- Patients have reported that they have been able to sleep through the night or for five hour increments without pain
These short-term results, while encouraging, should not deter you from continuing use of the pump as your doctor has prescribed. Remember, collateral bypass arteries take at least 3 months to form and strengthen when the therapy regimen is followed. We want you to have permanent benefits!
Will the ArtAssist® device help if the artery blockage is located above the knee vs. below?
The ArtAssist® device is effective no matter where the blockage is on your leg. In fact, the first graph on the Physiological Mechanisms page shows an increase in blood flow to the popliteal artery (which is located in the knee area) when the blockage is in the patient’s thigh (femoral artery). The second graph shows that this improved circulation also extends to the foot.
Is this the same thing as a lymphedema pump or a pump that prevents deep vein thrombosis (DVT)?
No, ArtAssist® device Arterial Pump Technology is markedly different. Though pneumatic compression therapy is also being used to prevent DVT, lymphedema and edema, its clinical use for treating PAD is a relatively new concept. The ArtAssist® device is the only external pneumatic compression device optimized for increasing arterial blood flow. Clinical studies have determined the optimal parameters (timing, pressure, intervals, bladder placement, and patient position) to maximize arterial blood flow.
Are there any side effects to using the ArtAssist® device?
No, there are no known side effects associated with using this pump. In fact, some clinicians are using the ArtAssist® device in conjunction with other therapies to increase chances of limb salvage (see Dr. Eton’s trial with stem cell therapy).
How do I return the ArtAssist® device?
Renters can return the device and all accessories (excluding the compression cuffs – they are single-patient use) to ACI Medical in the same packing material in which it came. Please use the provided pre-paid shipping bill that was included in the manila envelope to call the shipping company and schedule a pick-up.
If you need assistance, call ACI Medical and we will be happy to help you.
How long has the ArtAssist® device been on the market?
This pump has been on the market since 1998. However, prior to introducing the product to the public, the ArtAssist® device went through years of extensive research. Though proven effective for treating peripheral arterial disease (PAD), research still continues today with the goal of exploring what compression therapy can do for different cases. See our Clinical Studies Page to read more.
What kind of research has been performed?
All of our clinical publications have been performed at university-based hospitals by vascular surgeons. All references and clinical publications are available on request or can be viewed on the Clinical Studies and Case Reports pages.
We have clinical publications showing that ArtAssist®…The Arterial Assist Device®:
- Increases popliteal blood flow using duplex ultrasonic imaging and increased skin flux using laser Doppler
- Delivers the optimal stimulus
- Is useful in healing ischemic, diabetic foot ulcers
- Increases walking distance in patients with intermittent claudication
- Is useful after infrainguinal bypass grafting
- Is efficacious for limb salvage in cases unsuitable for surgical revascularization
I need advice on my medical condition. Who should I call?
Patients need to consult their current physicians about their medical condition. The folks at ACI Medical are NOT doctors and cannot give medical instructions. We can only answer questions about the ArtAssist® device itself. As stated in the Rental Agreement that patients sign, the patient is to contact their doctor with questions they have and they should be continuously followed up by a physician.
Improvements have been shown in the popliteal artery and at the tissue level. There are at least two mechanisms by which the ArtAssist® device increases blood flow:
- While the patient is in a sitting position, there is 60 mmHg on the venous column due to hydrostatic pressure and 60 mmHg on the arterial column, plus whatever their mean arterial blood pressure is (e.g. about 40). So, on the venous side, there is 60 mmHg and on the arterial side, there is about 100 mmHg. First, the ArtAssist® device rapidly inflates the foot/ankle cuff at 120 mmHg, emptying out the veins of the foot and preloading the calf. One second later, the calf cuff rapidly inflates at 120 mmHg, emptying out the veins of the calf. By compressing all the tissues below the knee, a large volume of venous blood is emptied with venous pressure dropping close to zero. On the venous side, you have zero and on the arterial side you have 100. Where does that extra blood go? The increased arterial-venous gradient results in greater arterial inflow. After 3 seconds of compression, the pump rests for 17 seconds, letting the veins refill, and then it starts the process over again.
- A second mechanism of 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 (NO) and tissue factor pathway inhibitor (TFPI) 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 ArtAssist® device applies compression rapidly, within 300 milliseconds. The very rapid increase and decrease of the pump’s compression creates high shear rates intended to stimulate collateral formation.
For DME Dealers
ACI Medical is currently looking for distribution opportunities in Europe. Please contact us if your company is interested in this non-invasive solution for PAD
ACI Medical makes it easy for DME dealers to distribute ArtAssist® devices. You can…
- Purchase the pump, or
- Share revenue with ACI Medical
Sharing revenue brings you these advantages:
- NO capital outlay
- NO maintaining inventory
- NO cleaning, refurbishing, or repairing pumps
- NO obsolete units. As the pioneer of ArtAssist® Arterial Pump Technology, ACI Medical will send you the latest upgrades on par with the most recent research
- Get the prescription for the ArtAssist® device
- Work with & bill patient’s insurance provider
- Ensure patients use the pump properly
- Return pumps to ACI Medical
- ACI Medical bills you each month the rental pump is on a patient
Get in touch with us for more information! Toll free (888) 453-4356 or email@example.com
What does “ACI” stand for?
We’re pretty surprised by how often people ask us this question, so if you’re really that curious, here’s how our company was named.
This company was founded in 1984 by Ed Arkans, a biomedical engineer who did contract manufacturing jobs out of his garage on second-hand equipment. When it came time to register his modest operation as a legitimate company, Ed was at a bit of a loss as to what name he should give it. So he asked his case worker, “Well, what kind of names do people usually make for their companies?” to which the case worker responded, “They use a couple initials.”
So that’s the true story of what the “ACI” in ACI Medical stands for: A Couple Initials.