In vivo quantitation of platelet deposition on human peripheral arterial bypass grafts using indium-111-labeled platelets

Pumphrey, C W; Chesebro, James H.; Dewanjee, Mrinal K.; Wahner, Heinz W.; Hollier, Larry H.; Pairolero, Peter C.; Fuster, Valentín

doi:10.1016/s0002-9149(83)80136-2

Cited by 70 publications

(19 citation statements)

References 17 publications

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“…The excretion of both metabolites was increased for several days following insertion of a synthetic graft. Studies using radioactivity labeled platelets have shown a continuous deposition of platelets on Dacron grafts for several days, even for many years [13,15,16]. The present study shows that the platelet accumulation on the graft during the initial postoperative period is associated with signs of activation and release.…”

Section: Discussionsupporting

confidence: 54%

Synthetic arterial grafts cause prolonged increase in the in vivo formation of thromboxane and prostacyclin in humans

et al. 1987

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To evaluate the in vivo production of thromboxane A2 and prostacyclin their major urinary metabolites were measured in patients following graft replacement of the abdominal aorta. Specific methods based on gas chromatography-mass spectrometry were used to measure the urinary excretion of 2,3-dinor-TxB2 and 2,3-dinor-6-keto-PGF1 alpha. The excretion of these metabolites increased tenfold and almost fortyfold during post-operative Day 1 and remained elevated 6-10 days p.o. In a group undergoing cholecystectomy smaller changes of shorter duration were seen. It is concluded from this study that synthetic grafts cause prolonged increase in the in vivo formation of thromboxane A2 and prostacyclin. The reason for the increased TxA2 formation is probably platelet interaction with the foreign surface, whereas the increase of PGI2 could be part of a vascular defense against induced thrombotic activity. Those increases may have pathophysiologic implications.

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Section: Discussionsupporting

confidence: 54%

Synthetic arterial grafts cause prolonged increase in the in vivo formation of thromboxane and prostacyclin in humans

et al. 1987

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“…In some studies, protection against thrombosis of arteriovenous cannulae, 29 vascular shunts in the arm, 30 or vascular bypass grafts in the lower extremity 31 have been reported, and a beneficial effect on pregangrene of the lower extremity in patients with hypersensitive platelets and spontaneous platelet aggregation 20 has been reported.…”

Section: Fjg / Cumulative Death Rates From Atherosclerotic Vascularmentioning

confidence: 99%

Veterans Administration Cooperative Study on Antiplatelet Agents in Diabetic Patients After Amputation for Gangrene: II. Effects of Aspirin and Dipyridamole on Atherosclerotic Vascular Disease Rates

Colwell¹,

Bingham²,

Abraira³

et al. 1986

Diabetes Care

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We report the results of a randomized multicenter clinical trial on the effects of aspirin plus dipyridamole versus placebo on major vascular end points in 231 non-insulin-dependent diabetic men with either a recent amputation for gangrene or active gangrene. Primary end points were death from atherosclerotic vascular disease plus amputation of the opposite extremity for gangrene. There were 24 atherosclerotic deaths in the drug treatment group (21.8%) and 23 in the placebo group (19.0%). There were 22 patients in the drug treatment group (20.0%) and 29 patients in the placebo group (24.0%) with opposite-side amputations. Survival curve analyses revealed little difference between these groups for major vascular end points, total mortality, all amputations, or myocardial infarctions. The most noteworthy group difference was observed for cerebrovascular end points (strokes and transient ischemic attacks), with an incidence of 8.2% (9 patients) in the drug treatment group and 19.0% (23 patients) in the placebo group. We conclude from this study that antiplatelet agents have no effect on the primary vascular end points, vascular deaths and/or amputation of the opposite extremity, in this population. Similarly, no effects were seen on secondary vascular end points, except for a suggestion of protection versus strokes and transient ischemic attacks. However, this finding must be interpreted with caution, since it is a secondary end point and was found only after multiple analyses of the data.

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“…2' 3 Although deposition decreases in the subsequent 6 months, platelet accumulation remains readily detectable for periods of up to 10 years. 4 5 Aspirin plus dipyridamole, used early postoperatively when deposition is maximal, reduces "'In-labeled platelet uptake on Dacron or polytetrafluoroethylene arterial grafts in humans6' 7 and has been associated with improved short-term patency compared with placebo ther-6, [8][9][10] apy.…”

mentioning

confidence: 99%

Reduction of indium-111 platelet deposition on Dacron vascular grafts in humans by aspirin plus dipyridamole.

Stratton¹,

Ritchie²

1986

Circulation

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Aspirin plus dipyridamole reduces platelet accumulation on short-term Dacron vascular grafts in man. To determine whether drug inhibition of platelet deposition is sustained on older grafts, we studied 18 men aged 41 to 87 years who had Dacron aortic bifurcation grafts in place a mean of 43.4 months (range 9.8 to 121.0) before and during short-term therapy with aspirin (325 mg tid) plus dipyridamole (75 mg tid). During both the baseline and drug studies, indium-111 (1'In) platelet deposition was quantitated by two techniques, standard planar imaging performed at 24, 48, and 72 hr after injection of platelets and single photon emission computed tomographic imaging performed at 24 and 72 hr after injection. All analyses were performed in a blinded fashion. On both the planar and tomographic images, platelet accumulation on the graft was quantitated by a graft/blood ratio that compared activity in the graft to simultaneously collected whole blood 1 'In platelet activity. Aspirin plus dipyridamole reduced the tomographic graft/blood ratio at 24 hr (20.6 + 3.5 vs 17.3 + 2.5) (±+ SEM) and at 72 hr (29.0 ± 4.8 vs 25.0 ± 4.1) after injection of platelets (p = .02). Similarly, the planar graft/blood ratio was reduced at 24 hr (2.7 ± 0.5 vs 2.4 ± 0.5), 48 hr (3.7 ± 0.9 vs 3.1 ± 0.7), and 72 hr (4.0 ± 0.9 vs 3.6 ± 0.8) (p = .04). We conclude that aspirin (325 mg tid) plus dipyridamole (75 mg tid) reduces platelet accumulation on long-term Dacron vascular grafts. Circulation 73, No. 2, 325-330, 1986. AFTER PROSTHETIC ARTERIAL GRAFT placement, occlusion is a common complication, particularly for grafts of smaller caliber. Although the mechanisms of occlusion are multifactorial,' many studies in animals and in humans suggest that platelet accumulation may play a prominent role, either directly by the formation of occlusive thrombus or indirectly by stimulation of intimal hyperplasia. Studies of indium-i 1 1 ("'In)-labeled platelets have documented that platelet deposition is greatest early after arterial graft placement.2' 3 Although deposition decreases in the subsequent 6 months, platelet accumulation remains readily detectable for periods of up to 10 years.4 5 Aspirin plus dipyridamole, used early postoperatively when deposition is maximal, reduces "'In-labeled platelet uptake on Dacron or polytetrafluoroethylene arterial grafts in humans6' 7 and has been associated with improved short-term patency compared with placebo ther-6, [8][9][10] apy.Whether aspirin plus dipyridamole reduces platelet uptake on older grafts that have a lesser rate of platelet deposition, but a continued risk of occlusion, remains unclear. Prior studies have documented that other platelet inhibitory agents, including ticlopidine," suloctidil,'2 and sulfinpyrazone'3 do not reduce platelet accumulation on grafts greater than 9 months old. With two methods of platelet imaging, the hypothesis tested in this study was that aspirin (325 mg tid) plus dipyridamole (75 mg tid) would reduce "'In-labeled platelet deposition on Dacron grafts that ha...

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In vivo quantitation of platelet deposition on human peripheral arterial bypass grafts using indium-111-labeled platelets

Cited by 70 publications

References 17 publications

Synthetic arterial grafts cause prolonged increase in the in vivo formation of thromboxane and prostacyclin in humans

Synthetic arterial grafts cause prolonged increase in the in vivo formation of thromboxane and prostacyclin in humans

Veterans Administration Cooperative Study on Antiplatelet Agents in Diabetic Patients After Amputation for Gangrene: II. Effects of Aspirin and Dipyridamole on Atherosclerotic Vascular Disease Rates

Reduction of indium-111 platelet deposition on Dacron vascular grafts in humans by aspirin plus dipyridamole.

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