The compressions of the Circulator Boot are synchronized with the heartbeat. Most other boots are not so timed.

The boot may be timed to compress the leg after each heartbeat, every other heartbeat or every third heartbeat. It does not compress the leg during the moments of heart contraction and arterial inflow into the leg. In these options, it stands alone.

Timed with the heartbeat, it may have a compression number per minute equal to the pulse rate. Thus, for a man with a pulse of 80, 80x40 or 3200 compressions may be delivered during the usual 40 minute treatment. Compression boots approved for use in lymphedema or venous stasis commonly take 20-30 seconds to inflate, remain inflated perhaps a minute and then deflate over a few seconds; during their inflated periods they block blood flow into the ischemic leg and potentially may cause damage to such legs.

The Circulator Boot is timed to release the leg in anticipation of cardiac systole, thus suddenly dropping pressure in the aorta and allowing the heart to empty its blood more easily during systole. Both freeing the heart from the work of returning venous blood to the heart and decreasing the work of the heart contraction, it is a cardiac assist device.

Unlike other external cardiac assist devices and arterial-assist cuff devices, it limits its compression pressure to that commonly found in the end of the heart cycle (diastole). In this fashion it does not expel arterial blood from the leg but rather provides pressure to disseminate the arterial inflow around the leg. Again, unlike these devices which all employ cuffs, it uses a leg bag and does not push venous blood backward towards the foot potentially damaging the venous valves and producing venous insufficiency. Finally, unlike some other external cardiac assist devices, it is solely designed to use compressed air and thus spares the leg of the weight of a surrounding water bath.

The system is highly flexible allowing any desired portion of the leg to be treated: high groin to toes, midthigh to toes, high groin to ankle, knee to ankle or toes, calf to toes etc.

The system lends itself readily to treatment of infected ulcerated legs: the leg may be treated while immersed in bags containing antibiotic solutions. Such treatments may help debride and sterilize the ulcers.