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ArtAssist® and Fluorescent Angiography: First Prize at Desert Foot 2015

“Treatment of Non-Bypassable Critical Limb Threatening Ischemia with Ischemic Ulcers Utilizing ArtAssist Monitored with Fluorescent Angiography” takes first prize at a major medical meeting

Phoenix, AZ – The abstract committee awarded the presentation that monitored ArtAssist device treatment of limb-threatening conditions with fluorescent angiography first prize in the Non-Residency category at the annual Desert Foot meeting that took place from November 18-20, 2015. Thuy Le, DPM of Madigan Army Medical Center in Tacoma, Washington accepted the $1500 prize on behalf of the research team. Submitted abstract presentations at Desert Foot were evaluated based on scientific method, perceived importance, innovation, and evidence level.

According to the researchers, 12 million people in the United States are affected by Peripheral Arterial Disease. Those with PAD suffer from conditions caused by poor blood flow to the arteries outside the heart. Severe conditions include Critical Limb Ischemia, where treatment options indicate surgery to correct the issue. Ischemic ulcers that are difficult to heal are often a consequence of poor blood flow. Patients who cannot undergo a surgical revascularization are many times slated for partial or major limb amputation.

In recent years, the ArtAssist® device has entered the market with the claim that patients who cannot undergo surgical revascularization can be spared from major amputation. The ArtAssist® device uses a patented rapid compression sequence to stimulate increased arterial blood flow to the limbs. Patients use the device at home with a physician’s prescription.

The winning presentation covered the use of Novadaq’s LUNA™ Fluorescence Angiography with SPYQ technology to monitor the progress of non-operable patients who were treated with the ArtAssist® device to restore arterial blood flow to the limbs. LUNA™ technology allowed the Madigan AMC research team to visualize the changes in blood flow brought on by the ArtAssist® device with minimal risk to the study patients.

The first study patient presented with a persisting pressure ulcer that resisted multiple topical treatment modalities. Before and after images of the ulcer showed complete healing and significantly increased blood flow after two weeks of ArtAssist® device treatment.

The second study patient presented with a gangrenous toe that was amputated in an effort to stop the spread of the disease. When this was unsuccessful, the patient was faced with major amputation of the foot or above the knee. ArtAssist® device treatment was initiated to preserve the limb. The patient achieved full healing at the end of seven weeks.

Ultimately, the researchers concluded, the combined treatments of the ArtAssist® device, debridement, offloading, and topical wound care contributed to successful limb preservation. LUNA™ fluorescent angiography with SPYQ technology was an effective means of monitoring and quantifying the patients’ improvement.

The team’s final note:  consider the ArtAssist® device before amputating non-operable limbs.

Contact mario.n.ponticello.civ@mail.mil for references

Contact info@acimedical.com for the ArtAssist® device

View the winning abstract:

Treatment of Non-BypassableCritical Limb Threatening Ischemia with Ischemic UlcersUtilizing ArtAssistMonitored with Fluorescent Angiography

 

 

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Recent Research in IPC for Lower Limb Ischemia

artassist to treat lower limb ischemia

Lower limb ischemia caused by Peripheral Arterial Disease is a hot topic in medicine. Intermittent pneumatic compression therapy is being used to treat patients with ischemic limbs where conventional treatments (namely surgery) fail or cannot be used.

If you are interested in learning more about arterial pneumatic compression pump therapy to treat ischemic ulcers, ACI Medical encourages you to explore the growing research surrounding the ArtAssist® device.

The latest research comes from a presentation at the Society of Vascular Surgery Annual Meeting in June 2015. Excerpt from abstract:

Enhancing Neovascularization in Chronic Limb-Threatening Ischemia

Objectives: The shear stress stimulus needed to switch on arteriogenesis, attenuated in chronic limb-threatening ischemia (CLI), can be restored with intermittent pneumatic compression (IPC). IPC also increases inflow of
oxygenated nutritive blood, clears waste products of metabolism, and enhances the traffic of elements needed for neovascularization (NV). The circulating progenitor cell (CPC) population is also depressed in CLI. We hypothesize that NV will be promoted by IPC and CPC mobilization.

Continue reading…

Additional research begins to explore the effect of leg IPC on nitric oxide (NO) levels in the arm. Excerpt from abstract:

The effect of intermittent pneumatic compression of legs on the levels of nitric oxide related species in blood and on arterial function in the arm

Background: Intermittent pneumatic compression (IPC) of legs exerts beneficial local vascular effects, possibly through local release of nitric oxide (NO). However, studies demonstrating systemic transport of nitrogen oxide species and release of NO prompt the question of whether IPC could also exert nonlocal effects. We tested whether IPC (1) affects systemic levels of nitrite, S-nitrosothiols and red blood cell (RBC) NO, and (2) exerts vasoactive effects in the brachial artery (BA), although this hypothesis-generating pilot study did not investigate cause and effect relationship between (1) and (2).

Continue reading…

Additional studies surrounding the treatment of lower limb ischemia with IPC can be found on the Clinical Studies page under the Limb Salvage & CLI heading.

Contact ACI Medical to discuss all aspects of arterial IPC treatment, from ongoing research to how patients can easily obtain the ArtAssist® device for home use:

Toll Free (888) 453-4356 or info@acimedical.com

artassist to treat lower limb ischemia

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5th Annual Native American Health Care Conference – The ArtAssist® Device

The Fifth Annual Native American Health Care Conference takes place November 12-14, 2014 at the Morongo Casino Resort & Spa in Cabazon, California.

ACI Medical will be there with the ArtAssist® device to present and discuss solutions to diabetes-related complications in the Native American community, particularly in regards to diabetic foot ulcers.

According to the CDC:People with Diabetes by Race and Ethnicity, 2004-2006

  • American Indian and Alaska Native adults are twice as likely to have diagnosed type 2 diabetes than non-Hispanic whites
  • Rates of diagnosed diabetes among American Indians and Alaska Natives younger than 35 doubled from 1994–2004.
  • Data from the 2009 Indian Health Services’ (IHS) National Patient Information Reporting System (NPIRS) indicate that
    14.2 percent of American Indians and Alaska Natives aged 20 years or older who received care from IHS had diagnosed diabetes
  • In 2012, diabetes and its related complications accounted for $245 billion in total medical costs and lost work and wages. This figure is up from $174 billion in 2007

 Having diabetes increases a patient’s chances of foot ulcers that are slow to heal. If left untreated, diabetic foot ulcers will grow, become infected, and can eventually lead to limb amputation. It is of utmost importance that diabetics educate themselves on proper foot care and make regular visits to their health care teams.

artassist at native american health care conferenceSome patients have difficulties managing their diabetic foot ulcers and are now facing the prospect of a major amputation. The ArtAssist® device has been shown to restore circulation to the ulcer, facilitating wound healing and limb salvage. The system is non-invasive, user-friendly, and can be used at home or at a clinic.

Over 25 clinical studies from multiple, independent centers confirm that the ArtAssist® device is responsible for a significant increase in arterial blood flow to affected limbs.

  • Doubles or triples pain-free walking distance in patients with intermittent claudication
  • 86-94% limb salvage rate
  • Opens and strengthens collateral arteries, resulting in long-term benefits (arteriogenesis)

For more information, please visit these resources:

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“Silly” New Therapies that Gained Credibility

paul van bemmelen md phd

Paul van Bemmelen, MD, PhD

In a recent editorial in VEIN Magazine, vascular surgeon Paul van Bemmelen discusses why one new therapy deserves more consideration from the medical community:  the ArtAssist® device.

Many physicians are skeptical of this recently re-invented modality to non-invasively treat blocked arteries in the legs and feet. While it is reasonable to want to steer clear of medical “miracle products,” evidence supporting the ArtAssist® device’s efficacy is substantial and continues to grow.

Van Bemmelen cites several clinical trials from multiple centers focused on patients with intermittent claudication (walking pain) and critical limb ischemia (when the limb is threatened by lack of blood flow). In some trials, patients did not have the option of surgery to restore blood flow. The conventional alternative would have been eventual amputation.

With this new knowledge about the ArtAssist® device’s capabilities, van Bemmelen asserts that vascular specialists are running out of valid reasons to deem patients untreatable.

Read the article in its entirety at this link:  http://www.veindirectory.org/magazine/article/artassist_arterial

Paul van Bemmelen, MD, PhD is professor of surgery and practices vascular and endovascular surgery in Philadelphia, PA. He used the first ArtAssist® device prototypes on patients.


To learn more about ArtAssist®…The Arterial Assist Device® and the ordering process, visit ArtAssist® device homepage and explore the menu:  http://acimedical.com/artassist/

ArtAssist new therapies for PAD

The ArtAssist® device is a home-use medical treatment designed to increase arterial blood flow, promoting wound healing, limb salvage and collateralization (arteriogenesis).

 Prospective clinical studies mentioned in the editorial:

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Endothelial Activation is Central to Collateral Artery Growth in PAD Patients

Collateral artery growth is possible for patients with critical limb ischemia with the use of external pneumatic compression therapy. Many vascular specialists are skeptical of this notion because it sounds contradictory:  how can a completely non-invasive treatment improve microvascular circulation to the point that the limb is saved?

Efficacy lies in the activation of the endothelium by way of exerting shear stress on the vessel.

Vascular specialists have good reason to be wary of most compression pumps claiming to promote better circulation and limb salvage. This is because the developers of such pumps did not design their systems with the endothelium in mind, preferring instead to modify lymphedema pumps or DVT prophylaxes to exert more pressure on the patient’s limb at slow compression and decompression rates (two or more seconds). Little clinical evidence exists to support this technique and little thought was put into this type of system’s design for arterial disease treatment. Furthermore, with such compression pumps, little or no pressure is applied to the foot or watershed areas, limiting cutaneous blood flow in these regions.

Now, for the endothelium. When shear stress is exerted on a vessel, its inner lining naturally secretes vasodilators and anticoagulants such as nitric oxide and TcPO2. In effect, the vessel temporarily widens, allowing more inflow. This effect can only be achieved with rapid external compression and decompression (each less than 0.5 seconds). Over time, the daily application of shear stress will encourage the growth of existing collateral arteries, as seen below:

angiogram van bemmelen artassist arterial pump technology

Arteriogenesis (or collateralization/collateral artery growth) explains why patients have long-term results after stopping ArtAssist® device usage

The ArtAssist® device is the only external pneumatic compression pump designed to focus on collateral artery growth. It activates the endothelium with rapid compression and decompression rates in the foot, ankle, and calf regions. This addresses poor circulation and wounds present from heel to toe, as well as in the rest of the limb.

Acquiring an ArtAssist® device is simple and may be reimbursed by insurance in certain areas of the United States. Device technology experts can discuss medical benefits with both physicians and patients, and will also fulfill orders. Call or email ACI Medical to begin:  toll free (888) 453-4356 or info@acimedical.com.

ArtAssist Device collateral artery growth

The ArtAssist® device is available in the US and internationally.

 

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Vascular Meeting for August 2016

ACI Medical will be exhibiting at the Society of Vascular Ultrasound in Chicago, August 11-13, 2016. Our featured vascular technologies include:

We hope to see you there!

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New Review on Intermittent Pneumatic Compression Therapy

According to a new review in the Journal of Vascular Surgery, Intermittent Pneumatic Compression therapy to treat peripheral artery disease has so far seen promising results. However, Sheldon et al. believe there is much more to be explored if IPC device makers intend to optimize their machines for PAD.

This new review highlights the need for researchers to identify what physiological and molecular mechanisms are responsible for successful IPC therapy. Although the improvement of vascular circulation is an important factor in determining whether or not an arterial IPC device is effective, the authors of this review suggest that improving responses on a deeper level would bring IPC therapy to new heights.

ArtAssist Device Intermittent Pneumatic Compression TherapyAmong the IPC devices referenced in this review is the ArtAssist® device model AA-1000. Find the entire published review in the Journal of Vascular Surgery December 2013 issue.

 

 

 

 

Read the abstract here or download the PDF:

New Insights into the Physiologic Basis for Intermittent Pneumatic Limb Compression as a Therapeutic Strategy for Peripheral Artery Disease

Ryan D. Sheldon, MS, Bruno T. Roseguini, PhD, M. Harold Laughlin, PhD, and Sean C. Newcomer, PhD. Columbia, Mo; São Paulo, Brazil; and San Marcos, Calif. Journal of Vascular Surgery 2013; 58:1688-96.

The capability for externally applied rhythmic limb compressions to improve the outcomes of patients with peripheral artery disease has been recognized for nearly a century. Modern technology has permitted the development of portable and cost-effective intermittent pneumatic compression (IPC) systems to be made readily available for affordable at-home use. Mounting clinical evidence attests to the effectiveness of this strategy, with improvements in claudication distance rivaling those seen with exercise training or pharmacologic interventions, or both. However, owing to a lack of mechanistic knowledge, whether current application protocols are optimized for clinical outcomes is unknown. Traditional thinking has suggested that IPC transiently elevates blood flow, which is purported to relieve ischemia, improve vascular function, and promote vascular remodeling. Surprisingly, much ambiguity exists regarding the physiologic stimuli and adaptations that are responsible for the clinical effectiveness of IPC treatment. This review presents and critically discusses emerging evidence that sheds new light on the physiologic and molecular responses to IPC therapy. These novel findings highlight the importance of characterizing the phasic changes in the hemodynamic profile during IPC application. Further, these studies indicate that factors other than the elevation in blood flow during this therapy should be taken into account when designing an optimal IPC device. Lastly, we advance the hypothesis that manipulation of IPC stimulation characteristics could potentially magnify the documented clinical benefits associated with this therapy. In conclusion, recent evidence challenges the physiologic basis on which current IPC systems were designed, and further research to elucidate the basic and clinical outcomes of alternate stimulation characteristics is necessary.

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“Use Of The ArtAssist Device In The Treatment Of Critical Limb Ischemia” Presented at VEITHsymposium ™ 2013

ArtAssist Arterial Assist Device IPC

Non-Invasive Critical Limb Ischemia Treatment – VEITHsymposium ™

This marks the second year that ArtAssist®…The Arterial Assist Device® was discussed at VEITHsymposium.

This presentation from Professor Andrew N. Nicolaides reviewed the medical implications of ArtAssist® device therapy, as well as some of the clinical trials that were performed on patients with critical limb ischemia (CLI).

(CLICK HERE TO VISIT THE ABSTRACT PDF ONLINE)

“The ArtAssist device takes advantage of the high venous pressure in the veins in the sitting position. It provides rapid compression of the foot and andrew nicolaides veithsymposium presenterthen the calf to 120 mmHg for three seconds. The rapid compression ensures that maximum pressure is reached within 300 ms. This is repeated three times every minute. This intermittent pneumatic compression empties the veins and in the presence of competent venous valves the venous pressure at the ankle is reduced to 15 mmHg. There is no effect on the arterial pressure which remains 180 mmHg. As a result dP becomes 180-15=165 mmHg. This increased dP results in increased arterial flow by 114% (1).

Arteriogenesis

Most notably, Prof. Nicolaides attributes the long-term benefits of ArtAssist® device therapy to the natural phenomenon of arteriogenesis. This means that over time, patients who use the device daily can be subject to the non-invasive remodeling of their vascular tree. Existing collateral vessels are encouraged to grow and provide much needed blood to the extremities.

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Visit ACI Medical at Desert Foot 2013

Desert Foot, the High Risk Diabetic Foot Conference, takes place from November 20-22, 2013 in Phoenix, AZ.ArtAssist device with case report

If you are attending, we would love for you to stop by the ACI Medical booth to talk to Dana Lockrey, our National Account Manager.

You can contact him before the meeting at dana@acimedical.com regarding treatment with ArtAssist®…The Arterial Assist Device® for the non-invasive treatment of diabetic ulcers and PAD.

Dana has tremendous experience handling VA accounts and working with veterans.

Additionally, don’t forget to listen in on “Programmed Pneumatic Compression: New Advances in Arteriogenesis” on November 20 from 4:20 to 4:40. Groundbreaking research has been done on the effects of pneumatic compression therapy on non-operable patients with severe circulatory disease. To get an idea before the meeting, visit the Arteriogenesis section on our Clinical Studies page.

Click here to view the entire Desert Foot program online.

We hope to see you there!

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A Big Kudos to ACI’s Customer Service Team!

As you may or may not know, ACI Medical has a small business attitude when it comes to customers and clients. Even though we do distribute the ArtAssist® device through other (exceptional) organizations, we have always been involved in making sure patients are satisfied with their therapy. The ArtAssist® device has so much to offer for non-operable patients, but what really matters is when a support system comes through.

Here is a recent example of how our customer service team works to serve patients (letter is unabridged except for identifying information):

Dear Don,

My husband and I want to thank you for the expeditious service in receiving the ACI medical device.

I know that the device has improved his circulation. Due to his chronic health issues, (COPD, diabetic, kidney problems), the vascular surgeon said that my husband will no longer be a candidate for surgery. It is the ACI device that is currently maintaining proper circulation to his legs, feet, & toes.

I am an advocate for this device and have watched his ulcer wounds heal with consistent and proper use of the device.

Per our phone conversation on Monday, October 14, you advised me that I would receive another machine due to the unfortunate malfunction of the one that I originally received. Today, October 15th, Tuesday, at 9:30 AM eastern time, the doorbell rang and on our front steps was the new replacement.

Two words for your service, appreciation and gratitude. You too have now become a major contributor to my husband’s health and well being.

With much appreciation,

Carol W.

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