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Клинический санаторий

Intensified counterpulsation

Intensified counterpulsation

In short, it is a drug-free way to improve substantially blood supply of the internal organs. Taking into consideration the fact that all medicines improving blood supply lead to increased blood pressure and heart rate and because of that increase load on the heart muscle, there is no alternative to the method of intensified counterpulsation to improve blood supply.

How can we reach this effect? On hands, thighs, lower legs, buttocks we put cuffs, similar to the ones for blood pressure measurement. The cuffs are inflated and deflated synchronously with the heart cycle; periods of it determined by ECG. In the moment of systole, (heart reduction) cuffs are saggy and do not hinder blood flow. In the moment of the diastole (heart relaxation) when the semilunar valves prevent the return of blood into the left ventricle of the heart, the cuffs inflate and obstruct blood flow in the legs and hands; due to this the bulk of blood flows into the internal organs. According to American authors (Annual of the American College of cardiology, vol. 41, no. 11, 2003) the blood flow in the carotid arteries and renal arteries increased by 20% in abdominal aorta by 88%, in the trunk of left coronary artery by 18% -46%, in the right and left coronary arteries up to 109%.

The invention of a special kind of valves that allowed technically in very short periods of time (a fraction of a second) to blow off and inflate quite extensive cuffs, provided an opportunity to introduce INCP method into clinical practice. INCP served as a natural development of the well-proven method of intra-aortic balloon counterpulsation (IACP), based on the same mechanisms, but the balloon is inflated inside the lumen of the aorta, which improves blood circulation of heart and brain. G.A.Kantrowitz published the first results of the clinical application of IACP in patients with cardiogenic shock with a positive improvement of survival index in 1968. In Europe and Russia, clinical use of intra-aortic balloon counterpulsation started in 1968 by V.I. Shumakov. However, IACP, as any invasive method of diagnosis and treatment has a number of possible serious complications (bleeding, vessel damage, infectious complications). Therefore, it is not used on outpatient and sanatorium-resort stages of medical care.

What are the indications for INCP?

  • Coronary heart disease in the case of a technical impossibility or refusal of the patient from surgical myocardial revascularization;
  • Erectile dysfunction associated with vascular disorders;
  • Atherosclerosis of arteries of the lower limbs with a clinical picture of Charcot’s syndrome, including with trophic disorders;
  • Cerebral arteriosclerosis, rehabilitation after suffered ischemic stroke;
  • Renovascular hypertension in case of impossibility of surgical correction;
  • Embolism of a retina artery, optic nerve lesion resulting from the violation of the blood supply;
  • The need to enhance resilience to stress of athletes, fast recovery after intense workouts.

Contraindications to INCP:

  • Arrhythmia, not allowing to synchronize counterpulsation with ECG (atrial fibrillation, unicameral pacing);
  • Recently carried out (1-2 weeks ago) puncture and catheterization of major arteries (in connection with the possibility of bleeding from the puncture locus);
  • Expressed insufficiency of aortic valve (increased load on the heart with volume);
  • Aneurysm of thoracic or abdominal part of aorta;
  • Consequences of suffered thrombophlebitis, phlebothrombosis, threatening with embolic complications;
  • Decompensated arterial hypertension (arterial pressure;180/110 мм рт. ст.);
  • Coagulopathy and hemorrhagic diathesis;
  • Pregnancy.