ORIGINAL ARTICLES   

International Angiology 2001 June;20(2):131-5

Copyright © 2002 EDIZIONI MINERVA MEDICA

lingua: Inglese

Oxidative stress during peripheral angioplasty. Implication for late restenosis?

Roller R. E. ¹*, Nimmrichter V. ², Trinker M. ³, Seinost G. ¹*, Schnedl W. J. ¹, Pilger E. ¹*

From the Departments of 1Internal Medicine, 1*Division of Angiology, Karl Franzens University School of Medicine, Graz, Austria, 2Internal Medicine, Barmherzige Brüder, Graz, 3Internal Medicine IV, University of Vienna, Medical School, Vienna, Austria

Background. Percutaneous trans­lu­mi­nal angio­plas­ty (PTA) is rou­tine treat­ment for ­patients with periph­er­al arte­ri­al dis­ease (PAD). The pro­ce­dure induc­es local gen­er­a­tion of reac­tive oxy­gen spe­cies (ROS), such as H2O2. Since these have been shown to stim­u­late vas­cu­lar ­smooth mus­cle cell ­growth (VSMCG), we inves­ti­gat­ed per­ox­ide lev­els in ­patients with PAD dur­ing PTA and relat­ed these ­results to late clin­i­cal out­come.
Methods. Thirty ­patients (17 male, 13 ­female, 20 Fontain stage II, 10 Fontaine stage IV, ­median age 68 years) under­go­ing PTA of a 2-6 cm sten­o­sis of the femo­ral or pop­li­teal ­artery were includ­ed. The pro­ce­dure was per­formed suc­cess­ful­ly in all ­patients. At fol­low-up six ­months there­af­ter resten­o­sis was eval­u­at­ed by ­duplex sonog­ra­phy. Total per­ox­ide con­cen­tra­tions were deter­mined in plas­ma drawn ­before, 6, 24 and 48 hours after the pro­ce­dure by the “per­ox­ide activ­ity” assay, which is based on the reac­tion of horse­rad­ish per­ox­i­dase with plas­ma per­ox­ides, using tet­ra­meth­yl­ben­zi­dine as the chro­mo­gen­ic sub­strate.
Results. The ­median per­ox­ide level ­before angio­plas­ty was 280 μmol/L (range 47-549). Levels were high­er in ­patients with ­advanced dis­ease, in smok­ers and in ­patients with dia­betes. In ­response to angio­plas­ty, per­ox­ide lev­els ­increased with­in 48 hours (p<0.001). Six ­months after the pro­ce­dure, resten­o­sis was ­observed in 10/30 (33%) of ­patients. Clinical out­come was not depen­dent upon base­line or post­inter­ven­tion­al per­ox­ide lev­els.
Conclusions. Elevated per­ox­ide lev­els are seen in ­patients with ­advanced arte­rio­scle­rot­ic dis­ease and in those with dia­betes, but are not pre­dic­tive for late resten­o­sis.