Key result
Femoro-popliteal bypass surgery for critical limb ischemia increased platelet activation and aggregation at 24 hours and up to 2 years postoperatively despite adjunctive therapy.
Why the study?
How does platelet activation and aggregation change before, during, and after femoro-popliteal bypass surgery in patients with critical limb ischemia?
Observational
How does platelet activation and aggregation change before, during, and after femoro-popliteal bypass surgery in patients with critical limb ischemia?
Platelets in patients with critical limb ischemia exist in a primed state and exhibit increased activation after bypass grafting despite standard adjunctive therapy, which may contribute to graft occlusion.
Persistent activation despite therapy warrants caution assuming standard regimens suffice; leaves open whether novel agents improve graft patency.
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.
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Mohan et al. (2007) conducted an observational in Critical Limb Ischemia. Femoro-popliteal bypass surgery vs. Controls was evaluated on Platelet aggregation and activation. Femoro-popliteal bypass surgery for critical limb ischemia increased platelet activation and aggregation at 24 hours and up to 2 years postoperatively despite adjunctive therapy.
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