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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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“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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Health Technology Assessment of IPC in Ireland is Challenged by Surgeon

ArtAssist Device collateral artery growth
ArtAssist Arterial Assist Device IPC

ArtAssist®…The Arterial Assist Device®

Intermittent pneumatic compression (referred to as IPC)

As a pioneering technology, ArtAssist®…The Arterial Assist Device® faces resistance in the medical community at large. In this case, Ireland’s Health Information and Quality Authority (HIQA) cites the “lack of high quality, reliable evidence to support the widespread adoption of this technology” in its Health Technology Assessment (HTA).

The ArtAssist® device has been clinically shown to drastically improve circulation in patients with limb-threatening ischemia, a result of advanced peripheral arterial disease (PAD). Many doctors, including Mr. Sultan at the Galway Clinic, prescribe ArtAssist® device therapy to patients who are not candidates for surgical intervention.

Understandably, doctors responsible for the well-being of their patients may be skeptical of new technologies such as IPC to treat PAD. The fact remains, however, that the only “widespread” course of action after failed attempts at revascularization is amputation of the limb. Since PAD often affects the aged population, the aftermath of amputation can be extremely detrimental to a patient’s quality of life in addition to being a financial burden on the state.

Mr. Sultan, in response to the HTA report:

Sherif Sultan

Mr. Sherif Sultan, Galway Consultant Vascular and Endovascular Surgeon

“The question is, is it a safe procedure, does it save limbs, does it decrease pain and does it control ulcers? The answer in all these cases is yes.”

Mr. Sultan continues to say that he has saved over 500 limbs with this IPC technology over the past eight years, which would have otherwise been scheduled for amputation. Furthermore, numerous studies on this device have been published in Vascular and Endovascular Surgery, a peer reviewed medical journal. The cost of renting the machine for three months is comparable to one night in a hospital bed.

To read the article in full, please visit:  http://www.imt.ie/news/latest-news/2013/07/hta-on-ipc-is-challenged-by-surgeon.html?doing_wp_cron

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Taiwanese PAD patients have improved quality of life & better walking distances in this new IPC study

Unlike other studies for the ArtAssist® device, these researchers examined the effects of intermittent pneumatic compression (IPC)

ArtAssist Arterial Assist Device IPC therapy

ArtAssist®…The Arterial Assist Device®

therapy on PAD patients suffering from infrapopliteal diffuse or multiple segmental lesions and who were at risk of amputation.

Click here to view the abstract.

 

Patients were separated into study (n=23) and control (n=8) groups and were given the following tests before and after the study period:

  • 6-minute walking test to examine claudication distance.
    Results: 
    duration and initial and absolute claudication distances significantly increased in study group
  • Transcutaneous oxygen tension (TcPO2).
    Results:  significantly increased in distal end of target limb after IPC therapy
  • Quality of Life (Short-Form 36 questionnaire):
    Results:  significant changes in physical functioning, physical and emotional role functioning, bodily pain, and general and mental health after IPC therapy

The study group received ArtAssist® device therapy for three months, three hours per day. The ArtAssist® device rapidly compresses the foot, ankle, and calf at 120 mmHg approximately every 17 seconds. The rapid inflation and deflation of the cuffs is instrumental to the arteries’ vasodilation.

The significant improvements in walking distance, oxygen levels, and quality of life show both medical and lifestyle benefits for patients who are not candidates for surgical intervention.

To read more about the clinical trials conducted with ArtAssist®…The Arterial Assist Device®, please visit the Clinical Studies Page.

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Big meetings this week: Desert Foot & VEITHsymposium™

Starting tomorrow, two very important meetings will kick off and experts from ACI Medical will be attending both of them.

If you are attending Desert Foot 2012, the 9th Annual High Risk Diabetic Foot Conference, be sure to attend the 20 minute presentations given by Dr. Darwin Eton (University of Chicago) and Dr. Paul van Bemmelen (Temple University). Both will be talking about how pneumatic compression therapy with arterial pump technology can prevent amputations in non-reconstructible limbs. Both have extensive experience using the ArtAssist® device in a clinical setting.

Here is when you can hear them talk:

Paul van Bemmelen, MD
Wednesday, November 14 from 2:10 PM to 2:30 PM “Pneumatic Compression for Non-Reconstructible PAD”

Darwin Eton, MD
Thursday, November 15 from 5:45 PM to 6:05 PM “Combined Cell Therapy and Pneumatic Compression to Treat Limb Ischemia”

VEITHsymposium™ 2012 will be featuring Professor Andrew Nicolaides of the Imperial College of London. He has been invited to discuss non-reconstructible limb salvage using arterial pump technology during a 5 minute talk on Friday, November 16 from 6:46 AM to 6:51 AM (don’t forget to drink your coffee – hearing him talk is always a treat!). Professor Nicolaides has clinical experience with the ArtAssist® device as well.

As pioneers of ArtAssist®…The Arterial Assist Device® technology, we at ACI Medical invite and encourage you to contact us with your questions about anything from the device’s science to ordering one for your patient:
(888) 453-4356 or info@acimedical.com

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Peripheral Arterial Disease won’t wait ’til next September – keep your education going!

Just because PAD Awareness Month is over doesn’t mean the disease won’t persist. I’m glad there’s a month dedicated to PAD education – this means that from now on, you can carry on everything you learned and share this invaluable knowledge with those around you. Last month was also a reminder to me what an important role prevention plays; that diseases like PAD won’t stop to let their victims try to figure out what’s going on.

On that note, I’d like to thank all those on Twitter who have participated with the effort by sharing their expertise and their resources, as well as including my two cents on the big conversation. I learned a lot!

If September was not enough to get your fill of PAD education, take a look through our dedicated category, where you’ll find articles written by yours truly in regards to the ArtAssist® Arterial Assist Device® and links to various experts who deal with the many complications of PAD.

Have a great day and STAY INFORMED!

All the best,

Diana

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“Rapid” compression technique to treat PAD

Rapid Compression:  How Fast is Fast Enough?

Compression pump systems for peripheral arterial disease treatment and wound care are becoming more and more popular these days. As more people seek treatment for conditions caused by poor circulation, the number of cases contraindicated for surgical intervention also rises. So, to find an alternative to amputation, some medical device makers are advertising their pumps as a solution.

In general, here’s what you’ll see:

  • Cuffs/sleeves:  can cover the foot & calf or just the calf
  • Pressure:  90 – 120 mmHg

Here’s a secret, though:  most of these “arterial pumps” are nothing but DVT prophylaxes or lymphedema pumps that are modified to exert more pressure. Minor adjustments such as these have been largely untested in a clinical setting and therefore yield fairly unpredictable results.

ACI Medical is the only device maker to have uncovered the most important aspect of compression therapy as a means of treating PAD:  rapid compression (under 0.5 seconds) that serves as a close physiological substitute for brisk walking.

ArtAssist device compression sequence

Unlike all other compression pumps, ACI Medical’s ArtAssist® Arterial Assist Device® was engineered on the premise of understanding the underlying physiology of increasing arterial blood flow and focusing on results that will benefit patients with critical limb ischemia. Since developers and researchers understood how important exercise was for patients with arterial disease, they engineered a device that would bring the important physiological benefits of walking to patients with limited mobility.

Early physiological studies led by Dr. Paul van Bemmelen, Professor Andrew Nicolaides, and others showed a great understanding of the vascular system of the legs. When we exercise, our calf muscles push blood rapidly through the veins to the heart where it can be recycled and directed back towards the leg muscles with essential nutrients. Therefore, in patients who have difficulty walking, it was essential to emulate the calf muscle’s role in pumping blood without having the patient do exercise.

So, when a patient uses the ArtAssist® device, it is as if the device system is “walking” for them. Patients do not experience pain and, over a period of about three months, benefits become long-term.

The real experts on Arterial Pump Technology are only a click or call away. Email info@acimedical.com or call toll free (888) 4 LEG FLO

Relevant clinical trials using the ArtAssist® device:

Rapid Intermittent Compression Increases Skin Circulation in Chronically Ischemic Legs with Infra-popliteal Arterial Obstruction.
van Bemmelen, P.S.; Weiss-Olmanni, J. and Ricotta, J.J. Div. of Vascular Surgery, State University of New York, Stony Brook.
VASA 2000;29:47-52

The Contributions of Arterial and Venous Volumes to Increased Cutaneous Blood Flow During Leg Compression. Eze, A.R.; Cisek, P.L.; Holland, B.S.; Comerota, A.J. Jr.; Veeramasuneni, R.; and Comerota, A.J. Philadephia, Pennsylvania, Charlotte and Gastonia, North Carolina. Annals of Vascular Surgery, 1998;12:182-186

Effects of Intermittent Pneumatic Compression of the Calf and Thigh on Arterial Calf Inflow: A Study of Normals, Claudicants, and Grafted Arteriopaths. Delis, K.T.; Husmann, J.W.; Cheshire, N.J.; and Nicolaides, A.N. Imperial College School of Medicine, St. Mary’s Hospital, London, UK. Surgery, 2000, Vol. 129, No. 2, p. 188-195

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A modified DVT pump for treating arterial disease? Don’t waste your time.

These days, intermittent pneumatic compression therapy is being used to treat edema, prevent deep vein thrombosis, and, more recently, similar devices have emerged claiming to treat peripheral arterial disease, a serious result of poor circulation in the limbs.

Some device manufacturers will tell you, “Hey, this pump that we use to prevent DVT and reduce edema can ALSO be used to treat arterial disease if you just kick the pressure up a notch.” Or at least they think so. It’s still a compression pump, right? And this DVT/edema/arterial pump will kill two birds with one stone, right? So why not?

unequal

The biomedical engineers here at ACI Medical and the vascular surgeons they work with can set this straight:  the simple answer is that, since arterial disease and venous disease are inherently different, they should be treated differently.

The companies that just modify lymphedema and DVT pumps and claim these systems can prevent amputations caused by peripheral arterial disease do so without much evidence to back them up. Do their pumps work? Maybe. Is that good enough? Come on.

The team that developed ArtAssist®…the Arterial Assist Device® for ACI Medical approached the arterial pump concept very differently. They realized early on that the new concept of treating peripheral arterial occlusive disease with non-invasive arterial pump compression therapy deserved a lot more thought. With that, they started from scratch and set these goals:

Understand the underlying physiology of increasing arterial blood flowThe ArtAssist Arterial Pump Device

Design a device based on this understanding

Determine the long-term clinical benefit(s) to patients with critical limb ischemia

Starting in the early 1990’s, ACI Medical’s team of biomedical engineers and vascular surgeons began a thorough progression of research and clinical trials that started with incorporating their most promising findings into the design and function of the ArtAssist® device.

Today, doctors from all around the country (and even some in other countries) prescribe this optimized arterial pump to their non-operable PAD patients because they know how critical it is for threatened limbs to receive optimized therapy that’s been proven to work again and again.

So it’s time for me to put up or shut up – view study abstracts on the ArtAssist® device at this link:

http://acimedical.com/artassist/clinical-studies/

My suggestion:  start with the History and Literature Review and our Scientific Brochure.

Then, call ACI Medical at our toll free number (888) 453-4356 or email Don, our Director of Sales & Marketing, at info@acimedical.com to talk to a real, live expert.

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