Integrity of venoarteriolar reflex determines level of microvascular skin flow enhancement with intermittent pneumatic compression

Objective To investigate whether intermittent pneumatic compression (IPC) augments skin blood flow through transient suspension of local vasoregulation, the veno-arteriolar response (VAR), in healthy controls and in patients with peripheral arterial disease (PAD). Methods Nineteen healthy limbs and twenty-two limbs with PAD were examined. To assess VAR, skin blood flow (SBF) was measured using laser Doppler fluxmetry in the horizontal and sitting positions and was defined as percentage change with postural alteration [(horizontal SBF − sitting SBF)/horizontal SBF × 100]. On IPC application to the foot, the calf, or both, SBF was measured with laser Doppler fluxmetry, the probe being attached to the pulp of the big toe. Results Baseline VAR was higher in the controls 63.8 ± 6.4% than in patients with PAD (31.7 ± 13.4%, P = .0162). In both groups SBF was significantly higher with IPC than at rest ( P P = .002 for calf compression, r=0.65, P P = .0002 for combined foot and calf compression). Conclusion The integrity of the veno-arteriolar response correlates with the level of skin blood flow augmentation generated with intermittent pneumatic compression, indicating that this may be associated with a transient suspension of the autoregulatory vasoconstriction both in healthy controls and in patients with PAD.