ArtAssist Arterial Pump Review: How It Works & Who It’s For | San Diego DPM

    Blog Series — 4 Parts — Advanced Foot & Ankle Center of San Diego

    Part 3 of 4

    The ArtAssist® by ACI Medical

    The device built from the ground up for arterial disease — and why the speed of its squeeze is the key to everything.

    By Dr. Philip Wrotslavsky, DPM, FACFAS · Advanced Foot & Ankle Center of San Diego

    1
    What Is Poor Circulation?
    2
    How Arterial Pumps Work
    3
    ArtAssist® Explained
    4
    Bio Arterial Plus & Comparison

    Not all compression pumps are arterial pumps. For decades, compression therapy has been used primarily for venous conditions — swollen legs, lymphedema, blood clot prevention. These venous pumps are very effective at what they do. But they were not designed to restore arterial blood flow to a critically ischemic limb.

    The ArtAssist®, developed by ACI Medical, was built from the ground up with a specific mission: to increase arterial blood flow. It was created by vascular surgeons, informed by research into the cellular biology of blood vessel healing, and has been in clinical use since 1998 — longer than any comparable arterial compression device on the market.

    What Makes ArtAssist® Different: The Speed of the Squeeze

    The defining feature of the ArtAssist® is how fast its cuffs inflate. In the current generation — using what ACI Medical calls EndoShear™ Technology — the cuffs go from zero to full pressure in under 300 milliseconds. That is less than one-third of a second.

    Inflation Speed Comparison
    ArtAssist®
    <300ms
    Typical venous pump
    2–5 seconds
    Human calf muscle
    ~0.4 sec per step
    The ArtAssist® matches and exceeds the rapidity of the natural calf muscle pump — the benchmark that arteriogenesis research was built around.

    The Engineering Behind the Speed

    Most pneumatic compression pumps use a small electric pump that slowly fills air chambers. The ArtAssist® stores compressed air in a high-pressure reservoir that is constantly refilled, allowing it to release pressure nearly instantaneously — like an air gun versus a water pistol. The stored energy is released all at once, not gradually built up.

    What the Research Shows

    Increase in blood flow to the skin of the feet during active use
    Measured by laser Doppler fluximetry
    Increase in pain-free walking distance in claudication patients
    Multiple clinical trials, sustained at 1-year follow-up
    >70%
    Of rest pain patients experienced resolution within 3 months
    Van Bemmelen et al., JAMA Surgery

    A landmark study in JAMA Surgery followed 14 consecutive patients with critically ischemic legs who were unsuitable for surgical revascularization — exactly the population typically told there are no options left. After 3 months of ArtAssist® therapy, a significant reduction in limb loss was observed versus a placebo group, with measurable improvement in toe pressures and clinical symptoms.

    “For patients who have run out of surgical options, clinical studies have shown the ArtAssist® can reduce limb loss — not just reduce symptoms.”

    What’s New in the Current ArtAssist® Device
    EndoShear™ Technology

    Adaptive pressure function — the device learns your individual physiology over time and fine-tunes each compression pulse to optimize the shear stress stimulus for your specific tissue.

    Under-300ms inflation and deflation — faster than any prior generation, maximizing nitric oxide release per cycle.

    FDA 510(k) compliant and patent-pending technology. The device looks and operates the same as prior models — the improvements are under the hood.

    Higher shear stress generation — targeting arteriogenesis more aggressively, particularly for patients with critical limb ischemia.

    Who Is ArtAssist® Best For?

    🩸Peripheral arterial disease (PAD)
    🚶Intermittent claudication (walking pain)
    🌙Rest pain and night pain
    ⚠️Critical limb ischemia (CLI)
    🩹Arterial and diabetic foot ulcers
    🦶Gangrene — adjunct limb salvage
    💉Before or after vascular surgery
    🧬Small vessel disease (no surgical target)

    Not Appropriate If You Have:

    Active deep vein thrombosis (DVT) or suspected blood clot · Pulmonary embolism · Acute, rapidly worsening arterial blockage · Active uncontrolled infection in the leg · Severe decompensated congestive heart failure. Discuss these with your physician before starting any compression therapy.

    Patient FAQ

    Q How does the device get to me?
    Your doctor prescribes the ArtAssist®. ACI Medical ships the complete system directly to your home, including the controller, garments, and an instructional video. Free telephone support is included. You don’t need to go to a clinic for treatment.
    Q How long do I use it each day?
    The standard recommendation is 3 hours per day. Most patients split this across two sessions — for example, watching the morning news and an afternoon show while sitting in a recliner. Your physician can adjust the regimen for your situation.
    Q How long until I feel a difference?
    Many patients notice improvement in rest pain and sleep quality within the first 3–4 weeks. Walking distance typically improves by months 2–3. The full arteriogenesis benefit develops over 3–6 months of consistent daily use.
    Q Does it hurt?
    The compression is firm at 120 mmHg, but the rapid cycling means you feel rhythmic squeezing rather than sustained pressure. Most patients describe it as a deep massage. It should not be painful. If you experience significant discomfort, contact your physician.
    Q Do I own it or rent it?
    The typical model is a rental for 3–6 months. Once therapy is complete, ACI Medical arranges pickup. The device can also be purchased outright. The garments (cuffs) are single-patient use and stay with you.
    Q Will insurance cover it?
    Both major insurance and Medicare cover the ArtAssist® under HCPCS code E0675 for qualifying diagnoses. Coverage generally requires documentation of your PAD diagnosis and that surgical options have been considered. Your doctor’s office can help navigate prior authorization.

    Dr. Wrotslavsky’s Clinical Perspective

    In my practice, the ArtAssist® is my first choice when the goal is long-term limb salvage in a patient who cannot have surgery. Its 25-year research track record, the confirmation of actual new vessel growth on imaging, and the endothelial shear stress mechanism give me confidence that consistent use is doing something biological — not just managing symptoms. For diabetic patients with arterial foot ulcers, this device has helped us avoid amputations that previously seemed inevitable.

    Up Next — Part 4
    The Bio Arterial Plus & How to Choose
    Bio Compression Systems’ arterial pump, a side-by-side comparison, and a practical guide for patients deciding between these two devices.

    PW
    Dr. Philip Wrotslavsky, DPM, FACFAS
    Double Board-Certified Foot & Ankle Surgeon · CEO & Medical Director, Advanced Foot and Ankle Center of San Diego