Authors' recommendations: This HTA examined the effectiveness of intermittent pneumatic compression (IPC) in patients with severe peripheral arterial disease who are not suitable for surgery or percutaneous transluminal angioplasty. The key findings of a systematic review of the evidence are as follows; There is a lack of high quality experimental studies examining the clinical effectiveness of IPC in this patient group. No randomised controlled trials, non-randomised controlled trials or prospective controlled before-and-after studies examining the outcomes of amputation-free survival, mortality, limb salvage or wound healing were identified. One prospective controlled before-and-after study involving a total of 31 patients reported improvements in claudication distance and health-related quality of life using the ArtAssist® IPC device. Conflicting reports about the severity of disease in this study population raise questions about the applicability of these results. One retrospective controlled before-and-after study involving a total of 48 patients reported improvements in limb salvage and wound healing using the ArterialFlow IPC device. Assessment of study quality indicated that both of these studies had a high risk of bias. In addition, both studies involved small numbers of patients. Six reports of case series involving the use of IPC in patients with critical limb ischemia who are not suitable for surgery or percutaneous transluminal angioplasty were identified. While these reported some promising results with regard to improved limb salvage, wound healing and pain relief, this study design is prone to bias and confounding. Case series are useful for generating hypotheses that can then be tested with the use of more rigorous study designs, but do not, on their own, provide strong evidence of the effect of interventions. No serious adverse events related to the use of IPC were reported. Among the less serious complications were pain and skin irritation associated with compression. From the limited data that is available, intermittent pneumatic compression appears to be a potentially beneficial treatment for people at risk of amputation who are not candidates for revascularisation, but more research is needed to confirm this.

Project Status: Completed

Year Published: 2013

URL for published report: http://www.hiqa.ie/publications/health-technology-assessment-hta-intermittent-pneumatic-compression-severe-peripheral-a

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Ireland

Organisation Name: Health Information and Quality Authority (HIQA)

Contact Address: Health Information and Quality Authority, George's Court, George's Lane,Smithfield, Dublin 7. PH : + 353 (01) 814 7464

Contact Name: info@hiqa.ie

Contact Email: info@hiqa.ie

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