Experimental assessment of thrombogenicity in vascular prostheses before and during prostaglandin E1 treatment.
The effect of prostaglandin E1 (PGE1; Prostavasin), a powerful platelet blocking agent, was assessed on various new synthetic or biological prostheses in a 6-min in vivo extra corporal arterio-venous (AV) shunt. In eight anaesthetised and heparinised minipigs (weight 25.1 +/- 1.9 kg) the following materials were tested before and during PGE1 infusion (alprostadil-alpha-CD; 40 micrograms/50 ml NaCl/50 min or 0.8 microgram/min): PTFE, (Gore-tex, TW, 4 mm ID); Xenograft, Biologic (Solcograft, 5 mm ID), (non-porous) and Dacron (Atrium, 4 mm ID); polyurethane 1 (Braun-Melsungen, 4 mm ID); polyurethane 2 (S. Gogolewski, 4 mm ID), (porous). Technetium-labelled platelet deposition and blood flow were measured; morphology was assessed by scanning electron microscopy (SEM) and histology. Compared to control levels, PGE1 infusion had a significant systemic effect on mean arterial pressure required by the protocol (MAP 82.6 vs. 66.6 mm Hg; p < 0.001) and flow (173.6 vs. 134.8 mm/min; p < 0.001). Standardised platelet counts per area showed a marked overall decrease from 197 to 130 counts/min/mm2; NS). The morphological assessment by SEM showed a slight increase of surface cellular deposition (score: 6.7 vs. 8.3), the histology score being unchanged (3.9 vs. 3.7). Looking at deposition of platelets for each prosthesis, the porous materials showed a net improvement after PGE1 treatment as compared to non-porous materials. We conclude that PGE1 may be of benefit by reducing platelet deposition in synthetic porous vascular prostheses in the early phase.
Walpoth
B H
BH
Department of Thoracic and Cardiovascular Surgery, University of Berne, Switzerland.
Amonn
A
A
Galdikas
J
J
Ris
H B
HB
Schaffner
T
T
Höflin
F
F
Schilt
W
W
Mettler
D
D
Nachnbur
B
B
Althaus
U
U
D000527:Alprostadil / Q000627:therapeutic use*; D000818:Animals; D001166:Arteriovenous Shunt, Surgical; D001705:Bioprosthesis; D001792:Blood Platelets / Q000187:drug effects / Q000502:physiology; D001794:Blood Pressure / Q000187:drug effects; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D006339:Heart Rate / Q000187:drug effects; D008855:Microscopy, Electron, Scanning; D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene; D011140:Polyurethanes; D013552:Swine; D013556:Swine, Miniature; D013927:Thrombosis / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control*
D011093:Polyethylene Terephthalates; D011140:Polyurethanes; D011138:Polytetrafluoroethylene; D000527:Alprostadil