What is PAD

Peripheral artery disease (also called peripheral arterial disease) is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs. When you develop Peripheral Artery Disease (PAD), your extremities — usually your legs — don’t receive enough blood flow to keep up with demand.

PAD leads to ischemia (lack of oxygen), which leads to poor wound healing, pain during walking and/or during rest.

FlowOx cause rappid fluctuation in blood flow to your limbs, this can also be beneficial if you have other types of long standing chronic wounds.

FlowOx enhance circulation and in particular microcirculation which alleviate some of the problems associated with ischemia.

Clinical evidence

FlowOx enhances circulation and in particular microcirculation which alleviates some of the problems associated Otivio and various clinical groups have evaluated the impact of FlowOx technology on several hundred patients. Rapid fluctuations in blood flow by applying FlowOx technology in healthy, on patients with peripheral arterial disease or patients with spinal cord injury have been documented and published in numerous scientific studies. Clinicians in Norway, UK and Germany have evaluated FlowOx on patients with critical limb ischemia, diabetes and spinal cord injury, often with positive outcome. Patients with chronic pain are currently being evaluated in a clinical trial in Scotland. Additional data is being collected in clinical trials on patients with chronic wounds

See all Clinical Evidence here

Case reports

The effects of intermittent negative pressure on macro-and microcirculation and functional exercise capacity: a single case report: Download

Preventing amputation using a novel device with intermittent negative pressure in a patient with severe lower limb ischemia: single case presentation. Download


Application of intermittent oscillating pressure on the lower extremity and its effect on macro- and microcirculation in the foot of healthy volunteers. The acute effects of intermittent negative pressure on foot circulation in healthy volunteers Download

The acute effects of lower limb intermittent negative pressure on foot macro- and microcirculation in patients with peripheral arterial disease Download

The effects of intermittent negative pressure on the lower extremities’ peripheral circulation and wound healing in four patients with lower limb ischemia and hard-to-heal leg ulcers: a case report Download

Intermittent negative pressure applied to the lower limb increases foot macrocirculatory and microcirculatory blood flow pulsatility in people with spinal cord injury Download

Intermittent mild negative pressure applied to the lower limb in patients with spinal cord injury and chronic lower limb ulcers: a crossover pilot study Download


Pulsating negative pressure applied locally, directly on the skin surface increases blood flow, probably due to a combination of dilation of the arterioles and an increased arteriovenous pressure gradient. The pulsating pressure will mechanically increase flow in the veins which have one-way valves. The reason for the pulsations is to avoid setting off the veno-arteriol reflex which constricts arteries when the veins are over-distended. That is also the reason why a constant negative pressure is counter productive

On the figure below (video shows the live Doppler signal), one can observe in the middle panel, how blood velocities (3) increase during the negative pressure period (1), whereas there is no change in the contra lateral control arm (5) not subjected to pressure pulses.

Pulsating negative pressure

Skin Blood Flow in a foot during FlowOx treatment
The video shows the live Doppler signal measuring blood flow velocity in a small artery in the foot (arteria dorsalis pedis). The recording is done on a patient with reduced peripheral circulation. Six seconds into the recording the negative pressure is applied for 10 second followed by a 7 second period of normal pressure. The sequence is repeated with the negative pressure starting again after 23 seconds and 40 seconds.

The FlowOx™ 2 system is indicated for the treatment of:

  • Peripheral arterial disease.
  • Diabetic and non-diabetic arteriopathic foot and leg ulcers.
  • Intermittent claudication and rest pain.
  • Foot and lower leg ulcers of mixed aetiology associated with immobility such as paraplegia following spinal injury.

Listen to Stine’s and Hans Thomas’s stories

Stine’s own story with Flowox
FlowOx™ first patient Hans Thomas