Increased prostacyclin production after percutaneous transluminal angioplasty of the iliac artery for atherosclerosis obliterans.
BACKGROUND
Endothelial prostacyclin production is modulated by blood flow (wall shear stress). Local plasma prostacyclin concentrations and hemodynamic parameters have therefore been investigated in patients with atherosclerosis obliterans before and after angioplasty. METHODS.


METHODS
Prospective study.


METHODS
Department of Surgery, Matsuyama Red Cross Hospital, Matsuyama, Japan.


METHODS
Nine lower limbs in eight patients with significant stenoses of the iliac artery were studied.


METHODS
blood samples were obtained from the femoral artery and femoral vein of nine lower limbs undergoing percutaneous balloon angioplasty of the iliac artery.


METHODS
Prostacyclin concentrations, radioimmunoassayed as 6-keto-prostaglandin F1 alpha, were measured before and after balloon dilatation. Femoral blood flow and the ankle-brachial pressure index (ABI) were measured using a Doppler velocimeter before and after the procedure. The femoral blood flow waveform was used to calculate the mean blood flow and shear stress variation.


RESULTS
Before angioplasty, the mean (+/- SEM) plasma prostacyclin concentration was 21.6 +/- 1.5 pg/ml in the femoral artery and 25.4 +/- 1.1 pg/ml in the femoral vein. After angioplasty, these values increased to 25.6 +/- 2.2 pg/ml (p < 0.05) and 32.8 +/- 1.8 pg/ml (p < 0.01), respectively. The pre-procedural ABI, mean flow rate, and shear stress variation were 0.596 +/- 0.071, 354.1 +/- 63.3 ml/min, and 69.1 +/- 9.9 dyne/cm2, respectively. Both ABI and shear stress variation increased after angioplasty to 0.738 +/- 0.076 (p < 0.05) and 111.1 +/- 24.2 (p = 0.0775) dyne/cm2, but the mean flow rate (287.1 +/- 61.1 ml/min after angioplasty) did not increase (p = 0.2002).


CONCLUSIONS
These results suggest that prostacyclin production increases after angioplasty, possibly due to increases in the intraluminal pressure and shear stress variation. This enhanced prostacyclin production may help to maintain arterial or bypass graft patency.
Onohara
T
T
Department of Surgery, Matsuyama Red Cross Hospital, Japan.
Fujinaga
Y
Y
Komori
K
K
Sugimachi
K
K
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001162:Arteriosclerosis Obliterans / Q000378:metabolism / Q000628:therapy*; D011464:Epoprostenol / Q000096:biosynthesis*; D005260:Female; D006801:Humans; D007083:Iliac Artery; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D011464:Epoprostenol