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Cochrane Database of Systematic Reviews

Intermittent pneumatic compression for critical limb ischaemia

Information

DOI:
https://doi.org/10.1002/14651858.CD013072Copy DOI
Database:
  1. Cochrane Database of Systematic Reviews
Version published:
  1. 11 July 2018see what's new
Type:
  1. Intervention
Stage:
  1. Protocol
Cochrane Editorial Group:
  1. Cochrane Vascular Group

Copyright:
  1. Copyright © 2018 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Authors

  • Ramy Elkady

    Correspondence to: Department of Vascular and Endovascular Surgery, Western Vascular Institute, University College Hospital, Galway, Ireland

    [email protected]

    [email protected]

  • Wael Tawfick

    Department of Vascular and Endovascular Surgery, Western Vascular Institute, University College Hospital, Galway, Ireland

  • Niamh Hynes

    Department of Vascular and Endovascular Surgery, The Galway Clinic, Galway, Ireland

  • Edel P Kavanagh

    Department of Vascular and Endovascular Surgery, The Galway Clinic, Galway, Ireland

  • Fionnuala Jordan

    School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland

  • Sherif Sultan

    Vascular Surgery, Galway University Hospital, Galway, Ireland

Contributions of authors

RE: drafting the protocol, obtaining copies of studies, selecting which studies to include, extracting data from studies, entering data into RevMan, carrying out the analysis, interpreting the analysis.
WT: drafting the protocol, obtaining copies of studies, selecting which studies to include, extracting data from studies, entering data into RevMan, carrying out the analysis, interpreting the analysis.
NH: drafting the protocol, obtaining copies of studies, selecting which studies to include, carrying out the analysis, interpreting the analysis.
EPK: drafting the protocol, carrying out the analysis, interpreting the analysis.
FJ: drafting the protocol, carrying out the analysis, interpreting the analysis.
SS: revising the protocol, drafting the review, serving as guarantor of the review.

Sources of support

Internal sources

  • No sources of support supplied

External sources

  • Chief Scientist Office, Scottish Government Health Directorates, The Scottish Government, UK.

    The Cochrane Vascular editorial base is supported by the Chief Scientist Office.

Declarations of interest

RE: none known.
WT: none known.
NH: has declared that she received money from Lake Region Medical for Peripheral Advisory Board membership and for consultation on Regulatory Documents Enterprise Ireland; and for her role as Bioinnovate Fellow working on medical device design at Boston Scientific. Payments to her and her institution were received from Cordis/Cardinal Health for her role as Principal Investigator in the INSIGHT post‐marketing surveillance trial of the INCRAFT AAA device. Her institution received payment from Gore Medical for providing training on endovascular aortic repair. She declares no competing interests, relationships, conditions, or circumstances that conflict with this review.
EPK: none known.
FJ: has declared that she and her institution received funding from the Health Research Board for a Cochrane Training Fellowship to facilitate Cochrane Review authoring.
SS: has declared that his institution has received money from Gore Medical for training of physicians on endovascular aortic repair; and from Cordis/Cardinal Health for his role as Prinicpal Invesigator in the INSIGHT post‐marketing surveillance trial of the INCRAFT abdominal aortic endograft.

Acknowledgements

We acknowledge the support of the Cochrane Vascular Group in preparation of this protocol, as well as assistance from the Cochrane Information Specialist (CIS) in designing and undertaking the search.

Version history

Published

Title

Stage

Authors

Version

2018 Jul 11

Intermittent pneumatic compression for critical limb ischaemia

Protocol

Ramy Elkady, Wael Tawfick, Niamh Hynes, Edel P Kavanagh, Fionnuala Jordan, Sherif Sultan

https://doi.org/10.1002/14651858.CD013072

Notes

Parts of the methods section of this protocol are based on a standard template established by Cochrane Vascular.

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

Table 1. Intermittent pneumatic compression compared with medical therapy alone for critical limb ischaemia at 12 months

Intermittent pneumatic compression (IPC) compared with medical therapy alone for critical limb ischaemia (CLI) at 12 months

Patient or population: patients with CLI

Settings: hospital

Intervention: IPCa

Comparison: medical therapyb

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No. of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Medical therapy

IPC

Amputation

12 months

Major adverse limb events (MALE)

12 months

Amputation‐free survival

12 months

Major adverse cardiovascular events (MACE)

12 months

Ulcer healing

12 months

Death

12 months

Health‐related quality of life

12 months

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval (CI)) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CLI: critical limb ischaemia; IPC: Intermittent pneumatic compression; RR: risk ratio.

GRADE Working Group grades of evidence.
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

aIPC involves sequential inflation and deflation of pneumatic pressure cuffs placed on the patient's limb. An automatic air source is connected to the cuff to allow intermittent inflation of the cuffs to pressures close to systolic pressure, followed by rapid deflation.

bMedical therapy can include any of the following: antiplatelet therapy, lipid‐lowering therapy, antithrombotic therapy, antihypertensive therapy, or smoking cessation therapy.

Figures and Tables -
Table 1. Intermittent pneumatic compression compared with medical therapy alone for critical limb ischaemia at 12 months