Intermittent Pneumatic Compression

Intermittent pneumatic compression (synonyms: IPC; Apparative intermittent compression; AIK) is a therapeutic procedure for the compression treatment of venous and lymphatic diseases. Of decisive importance for the therapeutic effect of the procedure is the so-called alternating pressure massage, with which a reliable decongestion of both acute and chronic lymphatic and venous edema can be achieved. The intermittent pressure of up to 120 -300) mmHg required for this purpose is generated via apparative compression.

Indications (areas of application)

  • Chronic venous insufficiency (CVI)/conductive venous insufficiency – is defined as hypertension (high pressure) in the venous system leading to changes in the veins and skin. CVI leads to venous outflow obstruction as well as microcirculatory disorders and trophic changes in the affected area (lower legs and feet).
  • Diabetic foot or diabetic foot defects.
  • Lipedema – chronic progressive, dysproportional, symmetrical subcutaneous fat proliferation.
  • Lymphedema – proliferation of tissue fluid caused by damage to the lymphatic system.
  • Edema diseases
    • Mixed forms of edema
    • Post-traumatic edema – following trauma (accident; injury), edema caused by this can be treated.
    • Venous edema (venous water retention) – venous congestion can lead to the development of venous edema depending on blood pressure and protein content (protein content).
  • Peripheral arterial occlusive disease (pAVK) – progressive stenosis (narrowing) or occlusion (closure) of the arteries supplying the arms / (more often) legs, usually due to atherosclerosis (arteriosclerosis, hardening of the arteries). This leads to a disturbance of the arterial circulation of the affected extremities (therapy under strict control).
  • Postthrombotic syndrome (PTS) – permanent consequential damage after thrombosis in the deep venous system (all stages).
  • Thromboembolism prophylaxis
  • Ulcus cruris venosum (lower leg ulcer) – this form of ulcer typically occurs in severe chronic venous insufficiency in the lower leg and is characterized by delayed healing.

Contraindications

Absolute contraindications

  • Decompensated heart failure (cardiac insufficiency with edema (water retention in the tissues) and dyspnea (shortness of breath) at rest).
  • Extended thrombophlebitis (acute thrombosis and inflammation of mostly superficial veins), thrombosis (vascular disease in which a blood clot (thrombus) forms in a vessel) or suspected thrombosis
  • Acute soft tissue trauma of the extremities
  • Occlusion of the lymphatic vessels
  • Acute inflammation of the skin in the treatment area.

Relative contraindications

Before therapy

Before intermittent pneumatic compression may be used, a detailed physical examination must be performed, especially of the affected body regions. Furthermore, a determination of general circulatory parameters and a check of blood flow should be performed before starting therapy.

The procedure

The basic principle of intermittent pneumatic compression is the generation of pressure by an air cushion through which targeted compression of blood and lymphatic vessels can occur. In addition to the placement of the air cushion, the compression is directly controlled by the air pressure. The device-based form of intermittent pneumatic compression allows pressure relief during rest phases and is therefore also suitable for immobile patients.In device-based compression, a distinction can be made between single-chamber systems and multi-chamber systems with several pressure chambers. In single-chamber systems, a defined pressure is built up over a certain period of time and released again after about 30 seconds. Multi-chamber systems have several pressure chambers in which pressure can be built up and released individually from the periphery to the center (e.g. from the foot to the thigh). The duration of application varies between 30-60 minutes and takes place 1 to 3 times a day.

After therapy

Following the use of the procedure, sonography (ultrasound examination) should be performed if there is a reasonable suspicion of thrombosis or thromboembolism.

Potential complications

  • Peroneal nerve damage (damage to the common peroneal nerve to cause failure of foot and toe extensors and pronation/inward rotation of the foot)
  • Pressure necrosis (death of tissue due to pressure).
  • Compartment syndrome (massive tissue swelling that can result in amputation in the absence of acute treatment).
  • Pulmonary embolism (blockage of a pulmonary vessel by a blood clot).
  • Genital edema