Platelet deposition after angioplasty is abolished by restoration of the endothelial cell monolayer.
OBJECTIVE
Percutaneous transluminal angioplasty of an atheromatous plaque causes endothelial desquamation and intimal dissection with the consequent formation of a thrombogenic flow surface. In this study we investigated the hypothesis that platelet deposition after balloon angioplasty may be decreased by rapid restoration of the endothelial cell monolayer, achieved by transluminally seeding angioplasty sites with endothelial cells.


METHODS
Bilateral external iliac angioplasty was performed in eight New Zealand white rabbits. One angioplasty site was isolated from the circulation and incubated with a supraconfluent endothelial cell suspension with a double balloon catheter; the contralateral angioplasty site was sham seeded with culture medium. The deposition of autologous indium 111-labeled platelets on the angioplasty sites was quantified 30 minutes after restoration of flow and was referenced to an undamaged segment of aorta that acted as a negative control.


RESULTS
Platelet deposition on the nonseeded angioplasty site (13.1 x 10(4) platelets/mm2) was significantly higher than on nondilated segments (3.4 x 10(4) platelets/mm2; p = 0.014). Restorationof endothelial cell coverage by endothelial seeding significantly reduced platelet deposition on dilated arterial segments to levels not significantly higher than in controls (3.6 x 10(4) platelets/mm2; p = 0.014).


CONCLUSIONS
These results illustrate that rapid reendothelialization of angioplasty sites decreases subsequent platelet deposition and may reduce the rate of acute arterial reocclusion complicating endovascular techniques.
Thompson
M M
MM
Department of Surgery, Leicester Royal Infirmary, United Kingdom.
Budd
J S
JS
Eady
S L
SL
Hartley
G
G
Early
M
M
James
R F
RF
Bell
P R
PR
D000800:Angioplasty, Balloon; D000818:Animals; D001011:Aorta / Q000033:anatomy & histology / Q000166:cytology; D001792:Blood Platelets / Q000502:physiology*; D002406:Catheterization, Peripheral / Q000295:instrumentation; D002470:Cell Survival; D002478:Cells, Cultured; D003239:Connective Tissue Cells; D004730:Endothelium, Vascular / Q000166:cytology / Q000502:physiology*; D005260:Female; D007083:Iliac Artery / Q000033:anatomy & histology / Q000166:cytology; D007205:Indium Radioisotopes; D008855:Microscopy, Electron, Scanning; D015539:Platelet Activation / Q000502:physiology*; D010976:Platelet Count; D011817:Rabbits; D014654:Vascular Patency
D007205:Indium Radioisotopes