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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
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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.
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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 postmastectomy lymphedema.
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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 selfapplied
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.
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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.
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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.
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Conclusion: Intermittent pneumatic compression is safe and well
tolerated and may offer additional benefit for patients
with postmastectomy lymphedema.
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Stimulation of lymphatic flow by sequential pneumatic
compression

Zelikovski A., Lymphology 1980
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Pneumatic compression in postmastectomy lymphedema
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maintenance study results

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Pneumatic compression in postmastectomy lymphedema
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Acute TX results

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