Acute platelet deposition after carotid endarterectomy in sheep: vein patch compared with gelatin-sealed Dacron and polytetrafluoroethylene patch closure.
OBJECTIVE
Patch angioplasty is commonly used to close the arteriotomy after carotid endarterectomy is performed. The purpose of this study was to determine whether any significant variations were present in platelet deposition for different patch sizes and materials.


METHODS
The study measured 111-indium-labeled uptake in the sheep to compare thrombus deposition for three different patch materials: autologous vein, gelatin-sealed Dacron, and polytetrafluoroethylene and for 6- and 12-mm patch widths. Platelet uptake was measured on the patch itself and on the artery wall that was opposite to the patch and that had undergone endarterectomy. Scanning electron microscopy was used to confirm the localization of the labeled platelets on the patch and on the surface that had undergone endarterectomy.


RESULTS
Although considerable variation was seen among animals, platelet accumulation was lowest in the vein patches compared with the prosthetic patches (p < 0.01), but the deposition on the gelatine-sealed Dacron was not significantly different from that on polytetrafluoroethylene patches. Platelet deposition on the artery wall that had undergone endarterectomy was considerably less than on the patch but was higher when a synthetic patch was used rather than a vein patch (p < 0.05).


CONCLUSIONS
Acute thrombus deposition after carotid endarterectomy was considerably less for vein patch closure than for synthetic patches. A 6-mm patch width caused less thrombus deposition both on the patch itself and on the artery wall compared with a 12-mm patch, but the difference was proportional to the patch width.
Margovsky
A I
AI
Surgical Professorial Unit, St. Vincent's Hospital, University of New South Wales, Sydney, Australia.
Meek
A C
AC
Lord
R S
RS
D000818:Animals; D001792:Blood Platelets / Q000502:physiology*; D016894:Endarterectomy, Carotid / Q000379:methods*; D005780:Gelatin; D007205:Indium Radioisotopes; D007601:Jugular Veins / Q000637:transplantation*; D008855:Microscopy, Electron, Scanning; D009942:Organometallic Compounds; D015125:Oxyquinoline / Q000031:analogs & derivatives; D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene; D019736:Prostheses and Implants; D012756:Sheep; D013927:Thrombosis / Q000097:blood / Q000209:etiology
D007205:Indium Radioisotopes; D009942:Organometallic Compounds; D011093:Polyethylene Terephthalates; C032950:indium oxine; D015125:Oxyquinoline; D005780:Gelatin; D011138:Polytetrafluoroethylene