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. 1982 Jul 1;69(7):380–382. doi: 10.1002/bjs.1800690708

Femoropopliteal bypass grafts—an isotope technique allowing in vivo comparison of thrombogenicity

M Goldman 1, H C Norcott 2, R J Hawker 3, C Hail 4, Z Drolc 5, C N McCollum 6,
PMCID: PMC11429042  PMID: 6213283

Abstract

Prosthetic femoropopliteal grafts attract platelet thrombus and often occlude in the months following implantation. Hence a technique to measure the in vivo thrombogenicity of different vascular substitutes in patients has been developed. In 28 patients the rate of accumulation of 111-indium-labelled platelets in saphenous vein, polytetrafluoroethylene (PTFE) and double velour Dacron femoropopliteal grafts was studied. One week postoperatively autologous 111In-labelled platelets were injected and the isotope emissions over the graft and contralateral leg counted. Graft thrombogenicity was calculated as the daily rise over 7 days in the ratio of counts over the graft to those over the contralateral leg. Mean thrombogenicity index (± s.e.mean) was greatest in the Dacron grafts at 0·24 ± 0·03 which compared with 0·13 ± 0·02 in PTFE (P<0·05). Saphenous vein was markedly less thrombogenic than either prosthetic graft with a mean index of only 0·025 ± 0·01 (P < 0·01). Platelet survival failed to differentiate the three graft materials, demonstrating that the direct measurement of 111 In platelet deposition was a more sensitive technique.

Contributor Information

M Goldman, Departments of Surgery and Nuclear Medicine, Queen Elizabeth Medical Centre, Birmingham.

H C Norcott, Departments of Surgery and Nuclear Medicine, Queen Elizabeth Medical Centre, Birmingham.

R J Hawker, Departments of Surgery and Nuclear Medicine, Queen Elizabeth Medical Centre, Birmingham.

C Hail, Departments of Surgery and Nuclear Medicine, Queen Elizabeth Medical Centre, Birmingham.

Z Drolc, Departments of Surgery and Nuclear Medicine, Queen Elizabeth Medical Centre, Birmingham.

C N McCollum, Departments of Surgery and Nuclear Medicine, Queen Elizabeth Medical Centre, Birmingham.

References

  • 1. Grimley  RP, Obeid  ML, Ashton  F  et al. : Long term results of autologous vein bypass grafts in femoropopliteal arterial occlusion. Br. J. Surg.  1980; 66: 723–6. [DOI] [PubMed] [Google Scholar]
  • 2. Veith  FJ, Moss  CM, Sprayregen  S  et al. : Preoperative saphenous venography in arterial reconstructive surgery of the lower extremity. Surgery  1979; 85: 253–6. [PubMed] [Google Scholar]
  • 3. Baumgartner  HR: The role of blood flow in platelet adhesion, fibrin deposition and formation of mural thrombi. Microvasc. Res.  1973; 5: 167–79. [DOI] [PubMed] [Google Scholar]
  • 4. Evans  G and Irvine  WT: Long term arterial graft patency in relation to platelet adhesiveness, biochemical factors and anticoagulant therapy. Lancet  1966; 11: 353–5. [DOI] [PubMed] [Google Scholar]
  • 5. Harker  LA, Slichter  SJ and Sauvage  LR: Platelet consumption by arterial prostheses: the effect of endothelisation and pharmacologic inhibition of platelet function. Ann. Surg.  1977; 186: 594–601. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 6. McCollum  CN, Kester  R, Rajah  SM  et al. : Arterial graft maturation: the duration of thrombotic activity in Dacron aortobifemoral grafts measured by platelet and fibrinogen kinetics. Br. J. Surg.  1981; 68: 61–4. [PubMed] [Google Scholar]
  • 7. McCann  RL, Hagen  P-O and Fuchs  JCA: Aspirin and dipyridamole decrease intimal hyperplasia in experimental vein grafts. Ann. Surg.  1980; 191: 238–43. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 8. Ross  R, Glomsett  J, Kariyq  B  et al. : A platelet dependent serum factor that stimulates the proliferation of arterial smooth muscle cells in vitro. Proc. Natl Acad. Sci. USA  1974; 71: 1207–10. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9. Yates  SG, Nakagawa  Y, Berger  K  et al. : Surface thrombogenicity of arterial prostheses. Surg. Gynecol. Obstet.  1973; 136: 12–14. [PubMed] [Google Scholar]
  • 10. Hawker  RJ, Hawker  LM and Wilkinson  AR: Indium (111-In) labelled human platelets: optimal method. Clin. Sci.  1980; 58: 243–8. [DOI] [PubMed] [Google Scholar]
  • 11. Ezekowitz  MD, Leonard  JC, Smith  EO  et al. : Identification of left ventricular thrombi in man using indium-111 labelled autologous platelets. Circulation  1981; 63: 803–10. [DOI] [PubMed] [Google Scholar]
  • 12. Stratton  JR, Ritchie  JL, Hamilton  GW  et al. : Left ventricular thrombi: in vivo detection by indium-111 platelet imaging and two dimensional echocardiography. Am. J. Cardiol.  1981; 47: 874–81. [DOI] [PubMed] [Google Scholar]
  • 13. Ritchie  JL, Stratton  JR, Hamilton  GW  et al. : Indium-111 platelet imaging for detection of platelet deposition in abdominal aneurysms and prosthetic arterial grafts. Am. J. Cardiol.  1981; 47: 882–9. [DOI] [PubMed] [Google Scholar]
  • 14. Davis  HH, Siegel  BA, Sherman  LA  et al. : Scintigraphic detection of carotid atherosclerosis with indium-111 labelled autologous platelets. Circulation  1980; 61: 982–8. [DOI] [PubMed] [Google Scholar]
  • 15. Hamlin  GW, Rajah  SM, Crow  MJ  et al. : Evaluation of the thrombogenic potential of three types of arterial graft studied in an artificial circulation. Br. J. Surg.  1978; 65: 272–6. [DOI] [PubMed] [Google Scholar]
  • 16. Kenny  DA, Berger  K, Wather  MW  et al. : Experimental comparison of the thrombogenicity of fibrin and PTFE flow surfaces. Ann. Surg.  1980; 191: 355–61. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 17. Sauvage  LR, Berger  KE, Woods  SJ  et al. : Interspecies healing of porous arterial prostheses. Arch. Surg.  1974; 109: 698–705. [DOI] [PubMed] [Google Scholar]

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