Does 111indium-platelet deposition predict patency in prosthetic arterial grafts?
The relationship between the rate of 111In-platelet deposition on vascular grafts and subsequent thrombosis has been examined in patients undergoing femoropopliteal by-pass. Sixty-seven patients undergoing femoropopliteal by-pass using vein, Dacron or PTFE were randomized to aspirin plus dipyridamole (ASA/DPM) or placebo. Autologous 111In-platelets were injected in the second postoperative week and Thrombogenicity Index (TI) calculated as the mean daily rise in the ratio of radioactivity graft/contralateral thigh. Graft patency was assessed to 1 year. Mean (+s.e.m.) TI at 1 week in 21 grafts that occluded within 12 months was 0.19 +/- 0.018 compared with 0.07 +/- 0.009 in the 38 that remained patient (P less than 0.001). Grafts with a TI less or greater than the median had a 90 per cent or 39 per cent cumulative 1-year patency, respectively (P less than 0.001). In the prosthetic grafts ASA/DPM reduced mean TI from 0.17 +/- 0.02 to 0.11 +/- 0.01 (P less than 0.02) and enhanced 1-year patency from 36 to 67 per cent (P less than 0.05). Following femoropopliteal by-pass TI related to subsequent graft patency. Radiolabelled platelet deposition therefore provides a guide as to how new materials or antithrombotic drugs may influence clinical graft thrombosis. Platelet inhibition reduced both graft thrombogenicity and subsequent occlusion.
D001241:Aspirin / Q000627:therapeutic use; D001792:Blood Platelets; D001807:Blood Vessel Prosthesis; D004176:Dipyridamole / Q000627:therapeutic use; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D006912:Hydroxyquinolines; D007204:Indium; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D015125:Oxyquinoline / Q000031:analogs & derivatives; D011150:Popliteal Artery / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis; D011868:Radioisotopes; D012306:Risk; D013927:Thrombosis / Q000175:diagnosis* / Q000517:prevention & control
D004338:Drug Combinations; D006912:Hydroxyquinolines; D009942:Organometallic Compounds; D011868:Radioisotopes; D007204:Indium; C032950:indium oxine; D015125:Oxyquinoline; D004176:Dipyridamole; D001241:Aspirin