Delivery of passivating proteins to sutures during passage through the vessel wall reduces subsequent platelet deposition by blocking fibrinogen adsorption.
Intraluminal vascular suture material, which attracts fewer than the expected number of platelets compared with the same biomaterial exposed to blood in vitro, differs from the untreated biomaterial in that it has been passed once through the vessel wall. The mechanism by which this apparently trivial maneuver reduces platelet deposition was investigated. Polypropylene suture (7-0 Prolene) was passed through human arteries (fetal and adult), and platelet deposition to the suture was measured in a standardized perfusion chamber. Single vessel passage of the sutures reduced platelet deposition by 68 +/- 23%, which contrasts sharply with the power of prostaglandin E1 (1 microM PGE1 is sufficient to abolish platelet shape change and aggregation), which inhibited only 11% of platelet deposition to the sutures. Aspirin treatment of the vessel (to prevent PGI2 formation) or endothelial stripping (to remove the ability to produce nitric oxide) had no effect on the degree of inhibition. Passage of the suture through a vessel analogue (expanded polytetrafluoroethylene) did not inhibit platelet deposition. 125I-fibrinogen adsorption to the suture after vessel passage was reduced to a degree similar to that of platelet deposition. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of proteins eluted from vessel-passed sutures revealed bands at 66, 47, and 16 kd. Western blotting indicated the presence of large amounts of albumin and hemoglobin, a moderate amount of haptoglobin, and only trace amounts of fibrinogen. When sutures were exposed to each of these proteins in vitro before perfusion, albumin and hemoglobin were found to reproduce the effect of vessel passage alone on platelet deposition. We conclude that albumin and hemoglobin adsorb to sutures during their passage through the vessel subendothelium.(ABSTRACT TRUNCATED AT 250 WORDS)
Johnson
P C
PC
Division of Plastic and Reconstructive Surgery, University of Pittsburgh, PA 15261.
Garrett
K O
KO
Brash
J L
JL
Cornelius
R M
RM
Kaplan
S S
SS
Warty
V
V
D000327:Adsorption; D000418:Albumins / Q000494:pharmacology*; D001158:Arteries / Q000601:surgery; D001241:Aspirin / Q000494:pharmacology; D001792:Blood Platelets / Q000502:physiology*; D015153:Blotting, Western; D005340:Fibrinogen / Q000378:metabolism*; D006454:Hemoglobins / Q000494:pharmacology*; D006801:Humans; D008855:Microscopy, Electron, Scanning; D010920:Placenta / Q000098:blood supply; D013536:Suture Techniques; D013537:Sutures; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*; D014656:Vascular Surgical Procedures
D000418:Albumins; D006454:Hemoglobins; D005340:Fibrinogen; D001241:Aspirin