Evaluation of Short-Stretch Compression Safety in Patients with ABI < 0.6 or TBI < 0.5

Introduction <br/>Compression therapy is commonly used for edema management, but its safety in patients with moderate to severe peripheral arterial disease (PAD) remains uncertain. Guidelines do not recommend compression for patients with an ankle-brachial index (ABI) &lt; 0.6. <br/><br/>Methods <br/>Eighteen limbs from patients diagnosed with moderate to severe PAD (ABI &lt; 0.6 or toe-brachial index (TBI) &lt; 0.5, range: ABI 0.22–0.84, TBI 0.1–0.53) undergoing reconstructive surgery or treatment of ischemic wounds at the Vascular Surgery Deparment at Regional Hospital Viborg between November 2023 and March 2024 were included. Toe pressures (TP), ABI, and TBI were measured before and after short-stretch compression. Comorbidities, including diabetes mellitus, cardiovascular disease, ischemic heart disease, peripheral neuropathy, and kidney insufficiency, were collected from medical records. <br/><br/>Results <br/>No significant differences were found between compression and no compression for TP (37 vs. 36.8 mmHg, 95% CI: 20.0–44.9 vs. 28.2–45.4, p = 0.95), ABI (0.49 vs. 0.55, 95% CI: 0.38–0.61 vs. 0.46–0.63, p = 0.10), or TBI (0.28 vs. 0.27, 95% CI: 0.22–0.33 vs. 0.21–0.33, p = 0.70). TP changes after compression exceeding 10 mmHg occurred in six limbs (2 increases, 4 decreases). No limbs had TP below 10 mmHg post-compression application. <br/><br/>Conclusion <br/>Short-stretch compression does not compromise TP, TBI, or ABI in patients with ABI &lt; 0.6 or TBI &lt; 0.5, suggesting it is a safe option for edema management in moderate to severe PAD, potentially enhancing wound healing, reducing hospitalization and improving quality of life.