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Panminerva Medica 1999 March;41(1):1-4

lingua: Inglese

Increased pros­tac­y­clin pro­duc­tion after per­cut­ane­ous trans­lu­mi­nal angio­plas­ty of the ­iliac ­artery for ath­ero­scler­o­sis oblit­e­rans

Onohara T., Fujinaga Y., Komori K., Sugimachi K.

From the Depart­ment of Sur­gery Mat­suya­ma Red ­Cross Hos­pi­tal, Mat­suya­ma,­Japan and * Sec­ond Depart­ment of Sur­gery Facul­ty of Med­i­cine, Kyu­shu Uni­ver­sity, Fukuo­ka, ­Japan


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. Design: pros­pec­tive ­study. Set­ting: depart­ment of Sur­gery, Mat­suya­ma Red ­Cross Hos­pi­tal, Mat­suya­ma, ­Japan.
Patients: ­nine low­er ­limbs in ­eight ­patients ­with sig­nif­i­cant ste­nos­es of the ­iliac ­artery ­were stud­ied. Inter­ven­tions: ­blood sam­ples ­were ­obtained ­from the femo­ral ­artery and femo­ral ­vein of ­nine low­er ­limbs under­go­ing per­cut­ane­ous bal­loon angio­plas­ty of the ­iliac ­artery. Meas­ures: pros­tac­y­clin con­cen­tra­tions, radio­im­mu­noas­sayed as 6-­keto-pros­ta­glan­din F1α, ­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.

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