SEQUENTIAL EXTERNAL COUNTERPULSATION INCREASES CEREBRAL AND RENAL BLOOD-FLOW

The purpose of this study was to evaluate the effect of sequential ext ernal counterpulsation (SECP) on cerebral and renal blood flow. The ef fect of SECP on carotid and renal artery blood flow was studied in 35 and 18 patients, respectively. With a portable unit, cuffs were applie d to the calves and thighs, sequentially inflated with air at the onse t of diastole, and deflated at the onset of systole. Carotid and renal artery Duplex studies were performed during intermittent SECP. Flow v elocity and flow velocity integral were measured at baseline and durin g SECP. Diastolic augmentation of carotid and renal artery flow veloci ty was observed in all patients. The mean carotid flow velocity integr al increased by 22% from 27.7 +/- 1.8 cm to 33.1 +/- 2.3 cm (P = 0.001 ). The mean renal artery flow velocity integral increased by 19% from 21 +/- 1 cm to 25 +/- 1 cm (P = 0.0001). With SECP, a new diastotic Do ppler flow velocity wave was observed, with an average peak carotid di astolic flow velocity of 56 +/- 4 cm/sec and an average peak renal art ery diastolic flow velocity of 40 +/- 2.5 cm/sec. This diastolic wave was 75% (carotid) and 68% (renal) as high as the systolic wave during SECP. In addition, with SECP the systolic wave increased by 6% and 8% in the carotid and renal artery, respectively (P = 0.02 and 0.006, res pectively). In conclusion, SECP significantly increases carotid and re nal blood flow. This noninvasive, harmless treatment may be useful to support patients with decreased cerebral and renal perfusion.