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Platelet Activation in Bypass Surgery for Critical Limb Ischemia

Academic Surgical Unit, St. Mary's Hospital, London, United Kingdom, irwin.mohan{at}doctors.org.uk

Dimitri P. Mikhailidis, MD, FACB, FASA, FFPM, FRCP, FRCPath

Department of Clinical Biochemistry, Royal Free Hospital, Hampstead, London, United Kingdom

Gerard P. Stansby, MBBChir, MA, FRCS GEN, MChir

University of Newcastle, Newcastle upon Tyne, United Kingdom

Platelet activation contributes to graft occlusion after bypass surgery. This study investigated platelet activation status before, during, and after bypass. Blood was taken preoperatively from patients undergoing femoro-popliteal bypass and at incision, after dissection, after ischemia, after reperfusion, 24 hours after surgery, and almost 2 years after bypass (and given aspirin or warfarin). Platelet aggregation was measured using a turbidimetric method and platelet activation with flow cytometry. Statistical analysis was performed using Mann-Whitney U and Wilcoxon's tests. Resting platelet activation was similar between controls and patients undergoing bypass. Platelet activation decreased at incision but remained highly reactive. Platelet aggregation increased after dissection and the ischemic phase but significantly decreased after reperfusion. Platelet aggregation and activation were increased at 24 hours and subsequently after bypass. Platelets in critical limb ischemia exist in the primed state and become activated by minimum stimuli. Increased platelet activation occurs after bypass grafting for critical limb ischemia despite adjunctive therapy.

Key Words: femoro-popliteal bypass • platelet • aggregation • peripheral arterial disease

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Vascular and Endovascular Surgery, Vol. 41, No. 4, 322-329 (2007)
DOI: 10.1177/1538574407302753


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This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Mohan, I. V. Articles by Stansby, G. P. Search for Related Content PubMed PubMed Citation Articles by Mohan, I. V. Articles by Stansby, G. P. Social Bookmarking                         What's this?