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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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Dec 3, 2015 By acimedical ArtAssist®…The Arterial Assist Device®, PAD, Wound Care
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.

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).

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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Oct 21, 2015 By acimedical ArtAssist®…The Arterial Assist Device®, PAD
The Rapid Cuff Inflator: 4 Tips for Maximum Efficiency

The primary goal of a rapid cuff inflator is to take the unnecessary stress out of venous insufficiency studies. While the machine is fairly straightforward to use, we at ACI Medical are always looking for ways to perfect the experience for vascular sonographers.

The VenaPulse® Hands-Free Augmentation Device will give sonographers standardized augmentations. However, it is up to the sonographer to know what works best for each patient’s unique physiology and medical condition.

With this simple guide, it is our hope that sonographers will be able to increase efficiency in the exam room. We will start at the beginning, when a patient is seen and studied for the first time.

1. Matching Cuffs to Patients

The first and most important step for cutting down on exam time is to decide which cuff is best for the patient walking through the door. Is the patient’s frame small, medium or large? Which valves do you need to study? How will the patient be positioned throughout the exam? Here are short profiles on the two types of inflation cuff provided in your VenaPulse® unit:

The Blue Cuff

VenaPulse Hands-Free Augmentation Device Rapid Cuff Inflator
Technologists have the option of placing a rapid inflation cuff anywhere along the patient’s leg.

Widely used for any patient regardless of size
Wraps anywhere from above the ankle to the upper thigh
For use in any patient position
Allows sonographer to visualize valves up to and including the sapheno-femoral junction

Also included with each VenaPulse® device is a black foot inflation cuff. This cuff does what the blue inflation cuff can’t: it allows you to study vessels just above the ankle.

The Black Foot Cuff

venapulse device rapid cuff inflator
Using the foot inflation cuff allows you to see perforators in the lower leg.

Best used to view perforators and valves in patients with normal- to large-sized feet
Ideal when patient is in relaxed reverse Trendelenburg position or standing with all weight on the non-studied leg
*Augmenting smaller feet may not produce adequate results due to lack of blood volume

2. Consider the Refill Time

Consider this: the average rate for arterial blood to flow back into the legs and feet is about 1.8 mL/second in a normal person and there are about 20 cc’s of blood in the foot. When the augmented area is full of blood, you will get a nice visual in the veins. However, if you do not wait long enough for the leg/foot to refill, you may get an unsatisfactory result.

We recommend waiting at least 15 to 20 seconds between augmentations to allow the patient’s blood to fill the area once again.

3. The VenaPulse® Device is Key to Charting

Your vascular lab can help minimize the variation between studies by using a rapid cuff inflator instead of hands. Even if the same patient sees two different sonographers, you can all be confident that each augmentation performed during other exams was the same as every other.

Just take note of the pressure used and you’re all set!

4. Take Care of Yourself During Every Exam

hand augment pain
Using a foot-operated rapid cuff inflator helps you avoid hand cramps.

All people have their physical limits, and sonographers are no exception. During a long exam, does your hand begin to cramp? How does your back feel after an hour and a half of repetitive bending and twisting?

Having a foot-operated rapid cuff inflator will certainly help you be more comfortable so you can focus on the task at hand.

Mint Medical Education also has a great article about how sonographers can survive venous insufficiency exams and make the lab more ergonomically friendly.

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Jan 19, 2015 By acimedical VenaPulse
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:

Fifth Annual Native American Health Care Conference web page
Diabetes Fact Sheet – CDC.gov
Diabetes: Minorities Face Greater Burden – CDC.gov
Diabetes among American Indians and Alaska Natives – CDC.gov
The ArtAssist® Device – Homepage
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Oct 6, 2014 By acimedical ArtAssist®…The Arterial Assist Device®
“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: https://www.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:

“Using intermittent pneumatic compression therapy to improve quality of life for symptomatic patients with infrapopliteal diffuse peripheral obstructive disease.” Chang ST, Hsu JT, Chu CM, Pan KL, Jang SJ, Lin PC, Hsu HC, Huang KC. Circ J. 2012;76(4):971-6. Epub 2012 Feb 4. Division of Orthopedic Surgery, Chia-Yi Chang Gung Memorial Hospital, Pu-TZ City, Chai-Yi Hsien, Taiwan.
“The Results of the Sequential Compression Biomechanical Device in Patients with Critical Limb Ischemia and Nonreconstructible Peripheral Vascular Disease.” Sultan, S.; Hamada, N.; Soylu, E.; Fahy, A.; Hynes, N.; and Tawfick, W. Dept. Vasc. And Endovasc. Surg., Western Vascular Institute, and Dept. Vasc. And Endovasc. Surg. Galway Clinic, Galway, Ireland. Presented at the 2010 Vascular Annual Meeting of Society for Vascular Surgery, Boston, Mass., June 14, 2010. J Vasc Surg 2011;54:440-7.
“A Randomized, Placebo-Controlled Limb Salvage Trial Using the ArtAssist Pneumatic Compression Device.” George Louridas, MD. University of Manitoba, Winnipeg, Canada, 2006.
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Sep 30, 2014 By acimedical ArtAssist®…The Arterial Assist Device®
The VenaPulse® Device in Aesthetics News Today

This month marks the first ever issue of Aesthetics News Today. In this inaugural issue, the Product Roundup section features

venapulse hands free augmentation device aesthetics news today
The VenaPulse® device provides hands-free, standardized augmentations

the VenaPulse® Hands-Free Augmentation Device. Glenbrook Hospital Radiology Department in Evanston, Ill. and Hoag Memorial Hospital Vascular Laboratory in Newport Beach, Calif. report their experiences with the device and comment on the role it plays in their facilities.

Varicose veins due to lower limb venous reflux can be a cosmetic issue as well as the cause of discomfort in the legs. Fortunately for patients, there are many treatments available for varicose veins and they do not often require a long recovery.

However, the process for diagnosing varicose veins in the legs is often physically strenuous for vascular technologists. Testing the veins requires technologists to bend and twist into uncomfortable positions in order to squeeze the vein with one hand. This task is made more difficult while trying to maintain a good image on the ultrasound. Technologists can request a colleague to help them with the diagnosis procedure, but this arrangement can reduce productivity. Furthermore, the disadvantage to manual squeezes is the potential

varicose veins
By National Heart Lung and Blood Institute. (Varicous veins.) [Public domain], via Wikimedia Commons

absence of consistency, which can produce inconsistent results.
According to a recent survey, 84% of diagnostic medical sonographers suffer from some sort of work-related injury.*

The VenaPulse® device provides consistent squeezes with the added benefit of improved ergonomics for technologists. By using a foot switch to operate a compression pump that inflates a wrap around the foot or ankle, the technologist can maintain a comfortable position while scanning. Use of the VenaPulse® device in the exam room reduces error and chances of injury.

*”Sonographer occupational musculoskeletal disorders: What are they and how can they be prevented,” Sound Ergonomics, LLC and Biodex Medical Systems, Inc.

To read through Aesthetics News Today article, you can download the reprint: VenaPulse® Users Share Insights: Considering Hands-Free vs. Manual Venous Reflux Exams?

ANT_0910-14_Vena_Pulse_HR-page-001 ANT_0910-14_Vena_Pulse_HR-page-002

“I want a VenaPulse® device for my facility!“

Venous Symposium Live Imaging
Assisted by the VenaPulse® Hands-Free Augmentation Device

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Sep 18, 2014 By acimedical VenaPulse
Ergonomics in the Exam Room: Preventing Work-Related Musculoskeletal Disorders

hand augment pain ergonomics
Bending, twisting, and hand cramps are some common precursors to MSD in medical diagnostic sonographers

When it comes to the typical vascular laboratory, one of the most dreaded tasks is the lower-extremity venous reflux exam. No matter how the patient is positioned, an RVT must either (a) strain herself to perform the augmentation, or (b) enlist the helping hand of a colleague. Both options pose different issues that can be detrimental to operations.

Ergonomic Impacts

Option A is the least ergonomic and has the potential to put the technologist out of work due to injury. Work-related musculoskeletal disorder (or MSD) is the number one cause of long-term illness absence in healthcare workers. In a survey, 84% of diagnostic medical sonographers suffer from some sort of injury. These injuries typically include carpal and cubital tunnel, epicondylitis of the elbow, neck and back strains, shoulder capsulitis, tendonitis, and tenosynovitis. Work activities known to cause MSD in sonographers include:

Repetitive motion
Forceful exertions or strain when pushing into a patient’s abdomen or compressing leg veins
Awkward postures or unnatural positions, commonly from reaching over patients during bedside exams
Economic Impacts

When a technologist misses work due to work-related MSD, no one wins. Economic impacts include:

Lost wages
More medical insurance claims and Worker’s Compensation claims
Increased sick and disability leave time
Compromised patient care
Option B, though it is the more ergonomic of the two given options, may not be much better. This time, the colleague helping with vein augmentations not only takes on some strain, but also becomes unavailable for her other tasks in the clinic.

Ideally, technologists should make use of lighter, more maneuverable equipment that promotes better ergonomics. For compressing leg veins during lower-extremity reflux exams, a portable, hands-free augmentation device is a recommended substitute for manual compression.

venapulse hands free augmentation device
The VenaPulse® device provides hands-free, standardized* augmentations

Sources:

Sonographer Occupational Musculoskeletal Disorders: What Are They and How Can They Be Prevented: https://www.soundergonomics.com/pdf/Biodex.pdf

Ultrasound Ergonomics: http://www.sdms.org/pdf/ergowhitepaper.pdf

*Prospective comparison of the pneumatic cuff and manual compression methods in diagnosing lower extremity venous reflux: https://www.acimedical.com/wp-content/uploads/2012/10/VenaPulse-ref-2-abstract.pdf