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

Copyright © 2000 EDIZIONI MINERVA MEDICA

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


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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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