Intraarterial 9-beta-methyl carbacyclin improves canine polytetrafluoroethylene graft patency.
This study examined the effect of 9-beta-methyl carbacyclin, a synthetic, stable prostacyclin analog, on canine polytetrafluoroethylene (PTFE) graft patency. Twenty-five dogs had 4 mm x 7 cm PTFE grafts implanted bilaterally into the femoral arteries. A subcutaneous infusion pump was used to deliver either saline solution (control) or 9-beta-methyl carbacyclin (Ciprostine) at 100 (CARB-100) or 200 ng/kg/min (CARB-200) through a femoral artery branch just proximal to one of the femoral grafts, with the contralateral graft serving as a noninfused control. Graft-platelet deposition (with 111In-labeled platelets) was measured between the fifth and seventh days, with patency determined on the seventh day. Dogs were classified as aggregators (AGG [+]) if the preoperative epinephrine-enhanced sodium arachidonate platelet aggregation was greater than 20%. CARB-200 infusion significantly improved ipsilateral graft patency (80%) compared with noninfused grafts (50%, p less than 0.05), or grafts in control and CARB-100 dogs (43%, p less than 0.05). Anastomotic platelet deposition was decreased bilaterally in CARB-200 dogs by 45% to 59% compared with CARB-100 and control dogs (p less than 0.05). With the exception of grafts infused with CARB-200, AGG (+) dogs had significantly lower graft patency (26%) than nonaggregator AGG (-) dogs (71%, p less than 0.01). CARB-200 infusion significantly improved graft patency in AGG (+) dogs (71%), compared with control and CARB-100-infused grafts (19%, p less than 0.025). Intra-arterial 9-beta-methyl carbacyclin improved early PTFE graft patency and inhibited platelet deposition in a severe canine model, independent of baseline platelet aggregation status, which also had an important effect on graft patency.
D000818:Animals; D001807:Blood Vessel Prosthesis; D004285:Dogs; D011464:Epoprostenol / Q000008:administration & dosage / Q000494:pharmacology* / Q000031:analogs & derivatives; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006083:Graft Occlusion, Vascular / Q000517:prevention & control*; D007205:Indium Radioisotopes; D007260:Infusion Pumps; D007261:Infusions, Intra-Arterial; D009942:Organometallic Compounds; D015125:Oxyquinoline / Q000031:analogs & derivatives; D010974:Platelet Aggregation / Q000187:drug effects*; D011138:Polytetrafluoroethylene; D011465:Prostaglandins, Synthetic / Q000008:administration & dosage / Q000494:pharmacology*; D014654:Vascular Patency / Q000187:drug effects*
D007205:Indium Radioisotopes; D009942:Organometallic Compounds; D011465:Prostaglandins, Synthetic; C032950:indium oxine; D015125:Oxyquinoline; D011138:Polytetrafluoroethylene; D011464:Epoprostenol; C045329:ciprostene