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Falk Cardiovascular Research Center
Stanford University School of Medicine
300 Pasteur Drive
Stanford, California 94305-5406 - (650) 723 6141
Division of Cardiovascular Medicine
Presented here are abstracts from a recently completed study by the Stanford
University
Center for Lymphatic and Venous Disorders. The study evaluates the use of
Pneumatic
Sequential Compression for the treatment of postmastectomy lymphedema.
The Stanford University Center for Lymphatic and Venous Disorder is the foremost
institution in the country studying the treatment of lymphedema. Bio Compression
pumps
were used exclusively in this study.
AN EVALUATION OF ADJUNCTIVE INTERMITTENT PNEUMATIC
COMPRESSION IN THE ACUTE TREATMENT OF POSTMASTECTOMY
LYMPHEDEMA
A. Szuba, R. Ashalu, SG Rockson
Stanford Center for Lymphatic and Venous Disorders,
Stanford University School of Medicine, Stanford, CA USA
Srockson@cvmed.stanford.edu
We investigated the safety and efficacy of adjunctive intermittent pneumatic
compression
(IPC) for the acute decongestive therapy of post-mastectomy lymphedema.
Twenty-three
patients were randomized to decongestive lymphatic therapy (DLT) with (Group II)
or
without (Group I) IPC. DLT included manual lymphatic drainage, bandaging, and
exercise,
performed daily. In Group II, 30 minutes of IPC was performed daily at 40-50 mm
Hg. Arm
volume was assessed by tank volumetry.
In Group I, the 11 patients achieved 26% acute arm volume reduction; in Group
II, the 12
patients achieved a mean volume reduction of 45.3% (p,<0.05). There were no
complications attributable to either DLT or IPC.
Conclusion:, IPC is generally safe and well-tolerated and appears to provide
synergistic
benefit when used with DLT in the acute decompressive approach to
post–mastectomy
lymphedema.
EVALUATION OF INTERMITTENT PNEUMATIC COMPRESSION AS
ADJUNCTIVE MAINTENANCE THERAPY IN POSTMASTECTORMY
LYMPHEDEMA
A. Szuba, R. Achalu, S.G. Rockson
Stanford Center for Lymphatic and Venous Disorders,
Stanford Univerity School of Medicine, Stanford, CA USA
Srockson@cvmed.stanford.edu
We studied the safety and efficacy of intermittent pneumatic compression therapy
as an
adjunct to standard decongestive lymphatic therapy in patients with stable
post-mastectomy
arm lymphedema.
Study design: Randomized, cross-over, 2 month study with 6 month follow-up
Patients and methods: 29 patients with postmastectomy arm lymphedema and without
evidence of active cancer were enrolled. Patients were randomized into two
groups.
Patients assigned to Group I were asked to continue their routine maintenance
therapy with
use of a Class II compression garment and self–applied manual lymphatic drainage
(MLD);
patients assigned to Group II were asked to use the intermittent pneumatic
compression
(IPC) pump for 1 hour daily (40-50mmHg) in addition to conventional therapy
(garments +
MLD). All patients crossed over to the alternate therapy after one month.
Patients who
elected to continue chronic use of the pump were evaluated after 6 months.
Clinical
evaluation was performed at the beginning of
the study, after the first and the second month and after six month follow-up.
The evaluation
included tank volumetry, skin tonometry, and measurement of range of motion.
Results: 27 patients completed the study. Two patients voluntarily withdrew.
There was a mean volume reduction of 89.5 ml during the month with IPC and
volume
increase of 32.7 ml during the month of routine maintenance therapy.
The difference was statistically significant (p<0.05). There was no difference
in tonometry
results. Of the 21 patients who completed chronic use of IPC, 19 were available
for analysis.
After 6 months, there was a further average volume reduction of 29.1 ml (not
statistically
significant). No adverse effects of IPC were observed.
Conclusion: Intermittent pneumatic compression is safe and well tolerated and
may offer
additional benefit for patients with postmastectomy lymphedema.
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