From Heart to Brain: EECP Therapy Gains Support from Chinese and U.S. Studies

Recently, the "Chinese Expert Recommendations on Enhanced External Counterpulsation for the Treatment of Ischemic Cerebrovascular Disease (2025 Edition)" was officially released. This is China's first set of expert recommendations specifically addressing the use of External Counterpulsation (EECP) for treating ischemic cerebrovascular disease. It was jointly developed by the Cerebrovascular Disease Group of the Neurology Branch of the Chinese Medical Doctor Association, the External Counterpulsation Branch of the Chinese Society of Biomedical Engineering, and the Guangdong Brain Science Application Society, providing an important reference for clinicians.

01  "Non-Surgical Coronary Artery Bypass"

EECP is a rehabilitation technology for cardiovascular and cerebrovascular diseases, a form of "passive exercise" known for its safety, non-invasiveness, simplicity of operation, and clear efficacy. It is hailed as a "non-surgical coronary artery bypass" (serving as an important adjunctive rehabilitation therapy).

Its working principle involves wrapping specialized air cuffs around the patient's calves, thighs, and buttocks. The control unit, based on the patient's cardiac cycle and a control algorithm, sequentially inflates the cuffs from distal to proximal during cardiac diastole, driving blood from the lower limbs and buttocks back to the aorta, thereby enhancing blood flow perfusion to the coronary arteries and vital organs. During cardiac systole, the cuffs are rapidly and synchronously deflated, reducing cardiac afterload.

02 Chinese Recommendations: EECP is Safe and Effective for Treating Ischemic Cerebrovascular Disease

Regarding the treatment of ischemic cerebrovascular disease, the "Chinese Expert Recommendations on Enhanced External Counterpulsation for the Treatment of Ischemic Cerebrovascular Disease (2025 Edition)" states that EECP is safe and effective for treating ischemic cerebrovascular disease and provides corresponding recommendations. The main contents are as follows:

Transient Ischemic Attack (TIA)：

For TIA patients, especially those combined with local cerebral hypoperfusion, early conventional medication combined with EECP treatment after onset helps improve cerebral blood flow perfusion and reduce cerebrovascular events.

Cerebral Infarction：

① For acute cerebral infarction patients with moderate to severe intracranial or extracranial atherosclerotic stenosis (50% ≤ stenosis rate < 99%) and mild to moderate neurological deficits (NIHSS ≤ 18), after condition stabilization and stable blood pressure (< 180/100 mmHg), it is recommended to initiate EECP treatment as early as possible (within 48 hours to 7 days after onset) in addition to conventional medication.

② The efficacy and safety of EECP treatment after acute vascular recanalization for cerebral infarction or for patients with cerebral small vessel disease are not yet clear. It is suggested that exploratory clinical research can be conducted under the premise of ensuring safety.

Cerebral Atherosclerotic Stenosis：

① For patients with asymptomatic severe carotid stenosis (70% ≤ stenosis rate < 99%) or symptomatic carotid stenosis combined with reduced cerebral perfusion, conventional medication combined with EECP treatment may help improve cerebral perfusion and delay the progression of carotid atherosclerotic plaques.

② The efficacy and safety of EECP treatment for intracranial atherosclerotic stenosis are not yet clear. It is suggested that exploratory clinical research can be conducted under the premise of ensuring safety.

03 Research from a Top U.S. Medical Center: Clear Efficacy of EECP

Numerous studies both domestically and internationally have shown that external counterpulsation can exert immediate and long-term hemodynamic effects. Research indicates that it not only increases peak diastolic blood pressure by 26%–157%, reduces systolic blood pressure by 6.3%–11%, and increases cardiac output by an average of 25%, but also regulates shear stress, improves vascular endothelial function, promotes angiogenesis, and improves collateral circulation.

Particularly noteworthy is a key study published in the International Journal of Angiology in 2024 by the Mayo Clinic Health System, the University of Minnesota, and the Department of Cardiovascular Medicine at the Mayo Clinic—a top U.S. medical center. This study conducted a retrospective analysis of EECP treatments performed at their center, involving 93 patients with severe angina or heart failure. The retrospective analysis showed that after a standard EECP treatment course, patients experienced significant relief of angina symptoms, markedly enhanced exercise tolerance, substantial improvement in quality of life, and a trend toward optimized blood pressure levels.

04 TL-EECP-100 External Counterpulsation Device

The realization of these research outcomes relies on precise and reliable EECP equipment. Tongling Bioscience focuses on the research, development, and production of medical devices in the cardiovascular field. Leveraging technical expertise accumulated during IABP development, the company has launched the TL-EECP-100 external counterpulsation device. This product features built-in self-developed advanced algorithms capable of accurately calculating counterpulsation timing and pressure values. Combined with self-developed solenoid valves, branded air compressors, and other high-quality hardware, it precisely controls the pneumatic system to achieve efficient counterpulsation and effective treatment.