Pneumatic Compression Device Treatment of Lower Extremity Lymphedema Elicits Improved Limb Volume and Patient-reported Outcomes

Objectives: Examine the effectiveness of an advanced pneumatic compression device (APCD) in reducing limb-volume (LV), and to evaluate clinician and patient-reported outcomes. Design: Device registry study. Materials and methods: Data were collected prospectively for 196 lower extremity lymphedema patients prescribed an APCD. Baseline and post-treatment LVs were calculated and clinical outcomes (skin changes, pain, and function) were assessed. Patient-reported outcomes and satisfaction utilizing a pre- and post-treatment survey were also evaluated. Results: 90% of APCD-treated patients experienced a significant reduction in LV with 35% enjoying a reduction >10%. Mean LV reduction was 1,150 mL or 8% (p<.0001). Greater baseline LV and BMI were strong predictors of LV reduction (p<.0001). Clinician assessment indicated that the majority of patients experienced improvement in skin fibrosis and function. Patient-reported outcomes showed a significant increase in ability to control lymphedema through APCD treatment, with an increase in function and a reduction in the interference of pain. 66% were "very satisfied" with the APCD treatment. Conclusion: APCD use is associated with consistent reductions in LV, with favorable patient-reported outcomes. Results demonstrate that reduction in LV and pain, combined with functional improvement and patient satisfaction can be achieved, providing tangible benefit for lower extremity patients. (C) 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.