EFFECT OF SEQUENTIAL INTERMITTENT PNEUMATIC COMPRESSION ON BOTH LEG LYMPHEDEMA VOLUME AND ON LYMPH TRANSPORT AS SEMI-QUANTITATIVELY EVALUATED BY LYMPHOSCINTIGRAPHY

F Miranda Jr, M Del C.J. Perez, M.L.V Castiglioni, Y Juliano, J.E Amorim, L.C.U Nakano, N de Barros Jr, W.G Lustre, E Burihan

Abstract


Sequential Intermittent Pneumatic Compression (SIPC) is an accepted method fortreatment of peripheral lymphedema. This prospective study evaluated the effect in 11 patients ofa single session of SIPC on both lymphedema volume of the leg and isotope lymphography (99Tcdextran) before SIPC (control) and 48 hours later after a 3 hour session of SIPC. Qualitativeanalysis of the 2 lymphoscintigrams (LS) was done by image interpretation by 3 physicians on ablind study protocol. The LS protocol attributed an index score based on the following variables:appearance, density and number of lymphatics, dermal backflow and collateral lymphatics in legand thigh, visualization and intensity of popliteal and inguinal lymph nodes. Volume of the legedema was evaluated by measuring limb circumference before and after SIPC at 6 designatedsites.Whereas there was a significant reduction of circumference in the leg after SIPC(p<0.05),there was no significant difference in the index scores of the LS before and aftertreatment. This acute or single session SIPC suggests that compression increased transport oflymph fluid (i.e., water) without comparable transport of macromolecules (i.e., protein).Alternatively, SIPC reduced lymphedema by decreasing blood capillary filtration (lymphformation) rather than by accelerating lymph return thereby restoring the balance in lymphkinetics responsible for edema in the first place

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