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Networks of tiny blood vessels - known as "collaterals" - make it possible for blood to detour around blocked or narrowed arteries. A difference in diastolic blood pressure between two arteries will stimulate the development of collateral vessels between them. Collaterals allow oxygenated blood to flow from a normal, "high pressure" artery to a blocked, "low pressure" artery, creating a natural bypass. Well developed collaterals can protect a patient from chest pain and prevent a heart attack, even if an artery to the heart is totally blocked. This is our body's natural response to coronary artery disease.
During EECP, lower extremity pneumatic cuffs are sequentially inflated during diastole, driving oxygenated blood from the legs and back to the heart. This raises the diastolic blood pressure in the healthy arteries, increases the pressure differential between the healthy and blocked arteries, recruiting and then enlarging collateral vessels between them. EECP is simply enhancing our body's natural response to coronary disease.
Clinical studies indicate that the "natural bypasses" created by EECP will persist, providing marked relief to patients with previously refractory symptoms. Patients with occluded bypass grafts or vessel renarrowing following angioplasty often do well with EECP. EECP is of special value in the care of patients who are not suitable candidates for an invasive revascularization procedure.
EECP is an extremely low risk, non-invasive, out-patient procedure. A full course of therapy typically involves 35 one hour treatments, carried out over seven weeks. The cost of EECP is approximately 1/6 that of bypass surgery and 1/3 that of angioplasty. At present, EECP is being covered by the majority of commercial insurance carriers, both of the major HMOs that serve the Toledo area, and Medicare.