Circulator Boot vs ECP

The average physician does not know the difference between the Circulator Boot and the ECP devices. This lack of knowledge has been a source of confusion for the insurance industry. We have added the paper of Dillon that was published in Angiology along with patent data to help clarify these differences.

For years our boot technicians were asked to repeatedly adjust our heart monitor as the pulse of the patient changed. As the number of beds in the clinic increased from one to two to sixteen, such individual attention proved difficult and our monitor was computerized to keep our compression phase in late diastole... or a fraction of a second before systole to allow for the negative pressure wave resulting from leg decompression to reach the heart. The latter was important in maximizing afterload reduction and increasing cardiac output. The patents, of course, of the ECP apparatus and specifically of Zheng et al had to be considered. The patent office was satisfied that these patents did not reveal apparatuses designed to release the leg specifically in end-diastole. In short, they are not end-diastolic boots. These differences are spelled out in the patent literature.

The Circulator Boot Corporation brought to the attention of HCFA the confusion that the wording of their coverage decision for the ECP device had caused regional Medicare Directors in their coverage of Circulator Boot therapy. Circulator Boot did not provide any data on the benefits of therapy and did not request a national coverage policy for Circulator Boot lest a negative decision negate various local coverage decisions and harm our current clients and their patients. The interested reader may find the resulting Medicare determination at the following page on its website: (Circulator Boot vs ECP decision).

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Comparison of Treatment Modalities in Augmenting Arterial Blood Flow to the Leg
Circulator Boot versus Other Boots
Pneumatic Boot Abstracts