Venous impulse foot pumps: should graduated compression stockings be used?

It is not known whether the effect of Foot Pumps (Novamedix, Andover, UK) is enhanced by simultaneous use of graduated compression stockings (by controlling calf compliance) or hindered (by restricting preload). To address this question, we studied 20 healthy volunteers with duplex ultrasound. The peak velocity in the popliteal vein was measured at rest with the legs flat, foot-up, and foot-down, then it was measured when the AV Impulse Foot Pump was activated. These measurements each were performed with and without graduated compression stockings. In each leg position, the use of simultaneous graduated compression stockings reduced the peak velocity. On physiologic grounds, graduated stockings should not be used simultaneously with Foot Pumps.