Barfield Michael, Winokur Ron, Berland Todd, Davis Sandi, Ralph Vicky, Chatham Nancy, Rockson Stanley, Maldonado Thomas S
University Surgical Associates, University of Tennessee Health Science Center, Nashville, TN.
Vascular and Interventional Radiology, Weill Cornell Medical Center, New York, NY.
J Vasc Surg Venous Lymphat Disord. 2025 Jan;13(1):101965. doi: 10.1016/j.jvsv.2024.101965. Epub 2024 Sep 1.
Advanced pneumatic compression devices (APCDs) have been shown to be effective in treatment of lower extremity lymphedema in the home setting. However, adherence to self-care has been poor, and APCDs require patients to remain immobile during treatment. We evaluated the safety and efficacy of a novel nonpneumatic compression device (NPCD) for treating lower extremity lymphedema vs an APCD.
A randomized, crossover head-to-head study was performed at nine sites in 2023. Patients were randomized to either the NPCD or a commercially available APCD. Patients used the randomly assigned initial device for 90 days with a 4-week washout period before a comparable 90-day use of the second device.
A total of 71 patients (108 affected limbs) with lower extremity lymphedema were analyzed. Compared with the APCD, the NPCD was associated with a greater mean decrease in limb edema volume (a mean limb volume decrease of 369.9 ± 68.19 mL [P < .05] vs 83.1 ± 67.99 mL [P < .05]). Significant improvement in Quality of Life was achieved for NPCD and but not for APCD treatment (score improvement of 1.01 ± 0.23 [P < .05] for NPCD vs 0.17 ± 0.18 [P > .05] for APCD). Patients reported greater adherence (81% vs 56%; P < .001) and satisfaction with the NPCD (78% vs 22%) compared with APCD. No device-related adverse events were reported.
The novel NPCD is an effective treatment for decreasing limb volume in patients with lower extremity lymphedema. The NPCD was more effective than an APCD and resulted in superior limb volume decrease, greater improved quality of life, adherence, mobility, and patient satisfaction.
高级气动压缩装置(APCDs)已被证明在家庭环境中治疗下肢淋巴水肿有效。然而,自我护理的依从性较差,且APCDs要求患者在治疗期间保持不动。我们评估了一种新型非气动压缩装置(NPCD)与APCD治疗下肢淋巴水肿的安全性和有效性。
2023年在9个地点进行了一项随机、交叉的头对头研究。患者被随机分为使用NPCD或市售APCD。患者使用随机分配的初始装置90天,在使用第二种装置进行类似的90天治疗前有4周的洗脱期。
共分析了71例下肢淋巴水肿患者(108条患肢)。与APCD相比,NPCD使肢体水肿体积的平均减少量更大(平均肢体体积减少369.9±68.19 mL [P <.05],而APCD为83.1±67.99 mL [P <.05])。NPCD治疗使生活质量有显著改善,而APCD治疗则没有(NPCD评分改善1.01±0.23 [P <.05],APCD为0.17±0.18 [P >.05])。与APCD相比,患者报告对NPCD的依从性更高(81%对56%;P <.001),满意度也更高(78%对22%)。未报告与装置相关的不良事件。
新型NPCD是治疗下肢淋巴水肿患者肢体体积减少的有效方法。NPCD比APCD更有效,导致肢体体积减少更显著,生活质量改善更大,依从性更高,活动能力更强,患者满意度更高。