Name of the Procedure:

Common Names: Non-segmental pneumatic compression therapy, pneumatic leg sleeve Technical/Medical Term: Non-segmental pneumatic appliance for use with pneumatic compressor, half leg (HCPCS Code: E0666)

Summary

Non-segmental pneumatic compression therapy involves using a specialized sleeve connected to a pneumatic compressor to apply consistent pressure to the lower leg. This helps improve blood flow and reduce swelling.

Purpose

This procedure is used to manage conditions such as lymphedema and chronic venous insufficiency, where fluid accumulates in the lower limbs. The primary goals are to alleviate swelling, reduce pain, and enhance mobility.

Indications

• Chronic lymphedema
• Chronic venous insufficiency
• Postoperative venous stasis
• Deep vein thrombosis (DVT) prevention
• Edema management

Preparation

• Patients should inform their healthcare provider of all medications they are taking.
• Wear loose, comfortable clothing to the appointment.
• No specific dietary restrictions or fasting required.
• A baseline assessment, including a physical examination of the legs, may be conducted.

Procedure Description

1. The patient is comfortably seated or lying down.
2. A specially designed pneumatic sleeve (half leg) is placed over the lower leg.
3. The sleeve is connected to a pneumatic compressor.
4. The compressor is activated to inflate and apply controlled pressure.
5. The sleeve may cycle through periods of inflation and deflation based on the specific therapy protocol.

6. The entire session typically lasts for 30-60 minutes.

   Equipment Used:

   • Non-segmental pneumatic appliance (half leg sleeve)
   • Pneumatic compressor

No anesthesia or sedation is needed for this non-invasive procedure.

Duration

Each session typically lasts between 30 and 60 minutes.

Setting

This procedure is usually performed in an outpatient clinic or at home with proper guidance.

Personnel

• Trained medical technicians or nurses
• Doctor or physical therapist for initial assessment and prescription

Risks and Complications

Common Risks:

• Skin irritation or redness
• Discomfort during initial sessions

Rare Risks:

• Increased pain
• Skin breakdown if used improperly

Any complications are managed by adjusting the pressure settings or reassessing the suitability of the therapy.

Benefits

• Reduced swelling and pain in the lower leg
• Improved mobility
• Prevention of complications like skin infections or ulcers from chronic swelling
• Relief can often be felt within a few sessions

Recovery

• Minimal to no recovery time; patients can resume normal activities immediately.
• Follow any specific instructions from healthcare providers about skin care and usage patterns.

Alternatives

• Manual lymphatic drainage (MLD)
• Compression stockings or wraps
• Medication to manage underlying conditions
• Exercise and physical therapy

Pros and Cons:

• Manual lymphatic drainage requires more frequent sessions and skilled therapists.
• Compression stockings may not be as effective for severe cases.
• Medication can have side effects and may not address physical symptoms comprehensively.

Patient Experience

During the procedure, patients might feel a gentle, rhythmic squeezing sensation but it should not be painful. After the procedure, they should feel some relief from swelling and discomfort. Any minor discomfort can usually be managed with adjustments to the device, and comfort measures such as cushioning can be provided.