Get the Boot to Reduce Lower Limb Amputations

"A novel idea to increase blood flow to the diabetic foot could result in the saving of thousands of limbs each year," according to John Nelson, DPM, CWS, associate dean of Clinics for the Barry University School of Graduate Medical Sciences.  Nelson, along with Dr. Jeri Gruenes, recently presented the findings from their study, An Evaluation of the Efficacy of the Circulator Boot Altering Hemodynamics of the Ischemic Lower Extremity and Foot, at the Annual Symposium on Advances in Wound Healing in Phoenix, Arizona.
           
In the United States, over 80,000 non-traumatic lower extremity amputations are performed mainly associated with diabetes and often with coexistent underlying peripheral vascular disease.  Peripheral arterial diseases are common and have a major impact on health. With the aging of the U.S. population, more and more patients are presenting with the signs and symptoms of lower extremity ischemia (restricted blood flow).  Despite advances in angioplasty and bypass techniques, the number of non-traumatic amputations associated with diabetes in the United States has continued to increase.
           
Nelson and the Barry researchers examined if the use of a cardio-synchronized instantaneous high pressure lower extremity pump would increase blood flow to the ischemic limb.  The therapy was applied through the use of the Circulator BootT, a left ventricular end diastolic pump which was administered to 20 patients for one hour, three times each week for four hours.  This apparatus applies a momentary high pressure gradient from the foot up through the leg during diastole, between heart beats.  This high pressure empties the venous system and facilitates reducing edema from subcutaenous tissue and lymphatics.  This decreases the resistance or afterload on the heart increases distal blood flow.  The study indicated an average increase in perfusion by 43% by the end of the fourth week of treatment.  Every pumped extremity demonstrated increased perfusion at the end of the fourth week.

"Improved wound healing and ultimately the prevention of amputation are potential outcomes with the Circular BootT or such an arterial assistive device," Nelson indicated.  For millions of Americans with diabetes or peripheral vascular disease this study may provide positive hope for the future.