Influence of graft material on blood rheology and plasma biochemistry following insertion of an infrainguinal bypass graft.
BACKGROUND
Occlusive arterial disease causes alterations in blood rheology and levels of potential thrombotic and fibrinolytic mediators. The aim of this study was to investigate the effect of graft materials on these parameters in patients undergoing successful infrainguinal revascularization.


METHODS
Some 186 consecutive infrainguinal grafts were observed for 12 months. Venous blood was sampled before operation and at 3, 6, and 12 months after surgery. Samples were assayed for thrombotic and rheological parameters. An area under the curve analysis was used to compare the effects of vein and synthetic grafting on these parameters in 99 patients whose grafts remained patent and free from stenosis.


RESULTS
Plasma levels of fibrin degradation products were significantly higher in patients with synthetic grafts (n = 46) than in those with autogenous vein grafts (n = 53) (median 274 versus 150 ng/ml; P < 0.001). There were no significant differences in plasma fibrinogen or any other parameters between the two groups.


CONCLUSIONS
Patients with a synthetic infrainguinal graft have a higher fibrin turnover than those with a vein graft. Further studies are required to determine whether this increase in fibrin turnover is an essential requirement to maintain patency of a synthetic infrainguinal graft.
Woodburn
K R
KR
Vascular Surgery Unit, Glasgow Royal Infirmary, UK.
Rumley
A
A
Love
J G
JG
Murray
G D
GD
Lowe
G D
GD
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000097:blood* / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D001809:Blood Viscosity / Q000502:physiology*; D005260:Female; D005337:Fibrin / Q000378:metabolism; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene / Q000627:therapeutic use*; D014654:Vascular Patency
D005338:Fibrin Fibrinogen Degradation Products; D005337:Fibrin; D005340:Fibrinogen; D011138:Polytetrafluoroethylene