Barry Researchers use Boot to Reduce Lower Limb Amputations

MIAMI — Friday - December 17, 2004

"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 Skin & Wound Care in Phoenix, AZ.

In the United States, more than 80,000 non-traumatic lower extremity amputations are performed. These are mainly associated with diabetes and often with coexisting underlying peripheral vascular disease. Peripheral arterial diseases are common and have a major impact on health. With the aging of the US population, more and more patients are presenting with the signs and symptoms of lower extremity ischemia. 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 extremities pump would increase blood flow to the ischemic limb. The therapy was applied through the use of the Circulator Boot™, a left ventricular end-diastolic pump which was administered to 20 patients for one hour, three times each week for four weeks.

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 subcutaneous tissue and lymphatics. This decreases the resistance or afterload on the heart and 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 Circulator Boot™ 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.

Dr. John Nelson
Professor
Barry University
11300 NE 2nd Avenue,
Miami Shores, FL 33161-6695
Phone number: 305-899-3000

Barry University

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