Treatment of Claudication With a Peristaltic Pulse Pneumatic Device
| Status: | Completed |
|---|---|
| Conditions: | Peripheral Vascular Disease, Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/2/2016 |
| Start Date: | November 2009 |
| End Date: | March 2011 |
| Contact: | Sharon R Besso, MS, ARNP |
| Email: | sharon.besso@va.gov |
| Phone: | 802-295-9363 |
Efficacy Study of a Peristaltic Pulse Pneumatic Device in the Treatment of Claudication
The purpose of this study is to evaluate the efficacy of a non-invasive peristaltic pulse
pneumatic device (PCD) in the treatment of intermittent claudication in patients having
documented peripheral arterial disease (PAD). The pneumatic device to be studied is FDA
approved for the treatment of venous disease. While anecdotal evidence exists supporting a
decrease in claudication symptoms, there are no previously published data on studies
employing this compression device in the treatment of arterial disease. The investigators'
primary hypothesis is that patients randomized to the intervention arm of the trial will
experience an increase in mean walking ability as compared to the group receiving medical
standard of care.
pneumatic device (PCD) in the treatment of intermittent claudication in patients having
documented peripheral arterial disease (PAD). The pneumatic device to be studied is FDA
approved for the treatment of venous disease. While anecdotal evidence exists supporting a
decrease in claudication symptoms, there are no previously published data on studies
employing this compression device in the treatment of arterial disease. The investigators'
primary hypothesis is that patients randomized to the intervention arm of the trial will
experience an increase in mean walking ability as compared to the group receiving medical
standard of care.
Peripheral arterial disease (PAD) is a common disorder, affecting 12% of adults older than
50 years of age. Approximately one third of these patients experience intermittent
claudication, defined as pain in the thigh or calf muscles during walking and that resolves
with rest. Lower extremity pain is often severe enough to significantly limit ambulation,
forcing many patients to seek medical care. Current treatments include two FDA-approved
medications, supervised walking programs, arterial angioplasty and/or stent placement, and
open arterial bypass surgery. The problem is that noninvasive treatments are oftentimes
ineffective, while invasive treatments are effective but expensive.
A non-invasive lower extremity treatment that has shown success in treating lymphedema and
venous insufficiency will be studied during this protocol to assess its effects on
claudication symptoms. Half of the participants in this prospective, single-center
randomized controlled trial will be treated with a pneumatic compression device in a home
treatment program, while half will receive standard medical therapy. If effective, potential
benefits are high, providing relief of personal disability and avoidance of costly surgical
intervention.
50 years of age. Approximately one third of these patients experience intermittent
claudication, defined as pain in the thigh or calf muscles during walking and that resolves
with rest. Lower extremity pain is often severe enough to significantly limit ambulation,
forcing many patients to seek medical care. Current treatments include two FDA-approved
medications, supervised walking programs, arterial angioplasty and/or stent placement, and
open arterial bypass surgery. The problem is that noninvasive treatments are oftentimes
ineffective, while invasive treatments are effective but expensive.
A non-invasive lower extremity treatment that has shown success in treating lymphedema and
venous insufficiency will be studied during this protocol to assess its effects on
claudication symptoms. Half of the participants in this prospective, single-center
randomized controlled trial will be treated with a pneumatic compression device in a home
treatment program, while half will receive standard medical therapy. If effective, potential
benefits are high, providing relief of personal disability and avoidance of costly surgical
intervention.
Inclusion Criteria:
- Consistent claudication symptoms for at least 6 months
- ABIs at rest as follows: 0.5>ABI<0.8 minimally on one leg
Exclusion Criteria:
- Refuses to consent
- Unlikely to be compliant with protocol
- Unable to perform treadmill test
- Current use of Cilostazol (Pletal) or Pentoxyphylline (Trental)
- Lower extremity surgery or endovascular procedure within the last 3 months
- Currently has a non-healing wound on either leg
- DVT in the past 3 months
- Unstable hypertension, angina, uncontrolled glucose levels
- Participating in a supervised exercise regimen
- Claudication medications regime changed within the last 3 months
- Diagnosis of Raynaud's Disease
- Requires a custom fabricated boot appliance
- Single limb amputees meeting inclusion criteria may participate in this study
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