Lipid peroxidation as a cause of lower limb swelling following femoro-popliteal bypass grafting.
We examined the role of free radical induced lipid peroxidation in lower limb swelling in patients following femoro-popliteal bypass grafting. In 20 patients undergoing this operation blood samples were taken from the femoral vein via a cannula before the femoral artery clamp was applied, just prior to and immediately after clamp release and at 10 min intervals thereafter for 1 h for measurements of malondialdehyde (MDA) and vitamin E. The concentration of MDA was significantly elevated at 40 min after reperfusion (mean +/- S.E.M., 573 +/- 83 pmol/ml) compared to just before clamp release (359 +/- 41 pmol/ml; p < 0.01). This was associated with a corresponding fall in the concentration of vitamin E at the time of peak MDA rise (5.68 +/- 0.28 to 5.29 +/- 0.28 mumol/mM cholesterol, p < 0.05) suggesting its utilisation as an antioxidant. The degree of oedema was related to the changes in MDA and vitamin E. Thus, in the 15 patients with greater than 10% increase in lower limb volume the rise in the concentration of MDA was 364 +/- 44 to 693 +/- 76 pmol/ml (p = 0.0001) while that in the five, whose swelling was less than 10%, was 344 +/- 40 to 559 +/- 243 pmol/ml (p = 0.25). A significant fall in vitamin E was found only in the group with greater than 10% lower limb oedema (5.90 +/- 0.33 to 5.40 +/- 0.34 mumol/mM cholesterol, p < 0.01), in comparison to those with less than 10% swelling (5.01 +/- 0.35 to 5.04 +/- 0.50 mumol/mM cholesterol).(ABSTRACT TRUNCATED AT 250 WORDS)
Soong
C V
CV
Vascular Surgery Unit, Queen's University of Belfast, Royal Victoria Hospital, Northern Ireland, U.K.
Young
I S
IS
Blair
P H
PH
Hood
J M
JM
Rowlands
B J
BJ
Trimble
E R
ER
Barros D'Sa
A A
AA
D002784:Cholesterol / Q000097:blood; D004487:Edema / Q000209:etiology* / Q000378:metabolism; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D007383:Intermittent Claudication / Q000378:metabolism / Q000601:surgery; D007866:Leg / Q000098:blood supply / Q000601:surgery; D015227:Lipid Peroxidation; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery*; D011183:Postoperative Complications; D014810:Vitamin E / Q000097:blood
D014810:Vitamin E; D008315:Malondialdehyde; D002784:Cholesterol