Key result
Preoperative venous occlusion platelet aggregation strongly predicts perioperative hypercoagulability in CEA.
Why the study?
The relationship between platelet aggregation and coagulo-fibrinolytic activities before and after carotid endarterectomy was unclear, particularly using venous occlusion test and impedance aggregometry.
Does preoperative venous occlusion testing predict hypercoagulable states after carotid endarterectomy?
Observational (n=34)
No
Does preoperative venous occlusion testing predict hypercoagulable states after carotid endarterectomy?
Preoperative venous occlusion testing using impedance aggregometry for ADP aggregation can predict early postoperative hypercoagulable states in patients undergoing carotid endarterectomy.
頸部頸動脈内膜剥離術(以下,CEA)施行患者(以下,B群)14名に対し,健常者(以下,A群)20名を対照にして,術前にvenous occlusion法(以下,VO法)を行い,VO法前後の血小板凝集能(以下,PA能)と各種凝固線溶系因子(以下,CF系因子)の変化を検討し,各変化率間の相関の有無を調べた.この際,PA能検査は通常のturbidimetric aggregometryとともに,CF系の動きも反映されるimpedance aggregometry法(以下,I法)を導入した.また,CEA前後でPA能とCF系因子の代表であるFDPを測定し,その変化率の相関を検討するとともに,術前に行ったVO法の各変化率との相関について検討した.その結果,術前VO法ではB群はA群に比しVO法後のCF系の発動が悪く,かつPA能の亢進傾向を示した.また,FDPなどのCF系因子の変化と最も強く相関を示したPA能検査は,I法によるADP凝集の変化であった.さらに,VO法前後のFDPの変化と最も有意な相関を示したのは,VO法前後ならびにCEA前後のI法でのADP凝集の変化であった.したがって,術前VO法によりI法によるADP凝集の変化を検討することで,CEA術後早期の過凝集,過凝固状態の出現を予知することができると考えられた.
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Asano et al. (1995) conducted an observational in Carotid stenosis (n=34). Venous occlusion test and carotid endarterectomy vs. Healthy controls and preoperative baseline was evaluated on Correlation between changes in ADP-induced platelet aggregation (impedance method) during preoperative venous occlusion test and after carotid endarterectomy (r = 0.83, p=<0.001). Changes in ADP-induced platelet aggregation measured by impedance during a preoperative venous occlusion test strongly correlated with postoperative changes (r=0.83, p<0.001), predicting perioperative hypercoagulability in carotid endarterectomy patients.
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