Labropoulos Nicos, Giuliano Karen K, Tafur Alfonso J, Caprini Joseph A
Division of Vascular Surgery, Department of Surgery, Stony Brook Medicine, Stony Brook, NY.
College of Nursing & Institute for Applied Life Sciences, University of Massachusetts, Amherst, Mass.
J Vasc Surg Venous Lymphat Disord. 2021 Sep;9(5):1241-1247. doi: 10.1016/j.jvsv.2021.01.008. Epub 2021 Feb 1.
The purpose of the present study was to compare common femoral vein blood flow enhancement during external mechanical compression using the novel, nonpneumatic Recovery Force Health Movement and Compressions (MAC) System (Recovery Force USA, Fishers, Ind), and four currently available intermittent pneumatic compression devices.
The MAC device was compared with the Kendall SCD 700 (Cardinal Health, Dublin, Ohio), Arjo Huntleigh Flowtron ACS900 (Arjo, Malmö, Sweden), ActiveCare+S.F.T. (Zimmer Biomet, Warsaw, Ind), and Circul8 (Ortho8, Rocklin, Calif). Doppler ultrasound measurements for each device were directly obtained from the right common femoral vein by a registered vascular technologist. The peak flow velocity and the time taken to reach the peak were calculated. For the MAC system only, the subjects were asked to walk a minimum of 500 steps while wearing the system, which was then checked for slippage. Leg size measurements were obtained using the noncontact Sigvaris Legreader XT5 (Vialis Ortopedia, Turin, Italy). The MAC device is not yet commercially available, and the present study was a prequel to clinical studies of venous thromboembolism prevention.
We recruited a broad range of 20 subjects who varied in age (mean ± standard deviation [SD], 50.5 ± 16.2 years), body mass index (mean ± SD, 26 ± 5.5 kg/m), gender (male, 25%; female, 75%), and right calf circumference (mean ± SD, 37.2 ± 5.5 cm). The peak flow velocity compared with the baseline measurements was significantly greater for the Recovery Force Health MAC System for three (Kendall SCD 700, P = .02; ActiveCare+S.F.T., P = .003; Circul8, P < .001) of the four comparisons. Although the difference was not significant, the Arjo Huntleigh Flowtron ACS900 (SD, 3.4 cm/s) had more measurement variability in the peak flow velocity compared with baseline than did the MAC System (SD, 1.9 cm/s). The MAC had a significantly (P < .001) faster rise time to peak flow compared with the comparison devices. It was the only device to achieve the target peak flow velocity over baseline of at least three times in every body mass index group. Finally, the MAC System met the goal of <2.5 cm of movement after ambulation in 100% of the measurements, with 75% of the measurements showing no movement.
The MAC System is a mobile device that remained in place during ambulation and provided more consistent external mechanical compression in the desired range compared with the other three devices included in the present study.
本研究旨在比较使用新型非气动恢复力健康运动与压迫（MAC）系统（美国恢复力公司，印第安纳州费舍尔）以及四种现有的间歇性气动压迫装置进行外部机械压迫时股总静脉血流的增强情况。
将MAC装置与肯德尔SCD 700（红衣主教健康公司，俄亥俄州都柏林）、阿若·亨特利Flowtron ACS900（阿若公司，瑞典马尔默）、ActiveCare+S.F.T.（捷迈邦美公司，印第安纳州华沙）和Circul8（奥索8公司，加利福尼亚州罗克林）进行比较。由注册血管技术专家直接从右股总静脉获取每个装置的多普勒超声测量值。计算峰值流速和达到峰值所需的时间。仅对于MAC系统，要求受试者在佩戴该系统时至少行走500步，然后检查是否有滑动。使用非接触式西格瓦里斯腿部阅读器XT5（维阿利斯矫形公司，意大利都灵）进行腿部尺寸测量。MAC装置尚未上市，本研究是静脉血栓栓塞预防临床研究的前奏。
我们招募了20名广泛的受试者，他们在年龄（平均±标准差[SD]，50.5±16.2岁）、体重指数（平均±SD，26±5.5kg/m）、性别（男性，25%；女性，75%）和右小腿周长（平均±SD，37.2±5.5cm）方面存在差异。在四项比较中的三项（肯德尔SCD 700，P = 0.02；ActiveCare+S.F.T.，P = 0.003；Circul8，P < 0.001）中，与基线测量值相比，恢复力健康MAC系统的峰值流速显著更高。尽管差异不显著，但与MAC系统（标准差，为1.9cm/s）相比，阿若·亨特利Flowtron ACS900（标准差，为3.4cm/s）的峰值流速测量变异性更大。与对照装置相比，MAC达到峰值流速的上升时间显著更快（P < 0.001）。它是唯一一个在每个体重指数组中均使目标峰值流速超过基线至少三倍的装置。最后，MAC系统在100%的测量中达到了行走后移动<2.5cm的目标，75%的测量显示无移动。
MAC系统是一种移动装置，在行走过程中保持原位，与本研究中包含的其他三种装置相比，能在所需范围内提供更一致的外部机械压迫。
