The influence of early surface thromboreactivity on long-term arterial graft patency

John D. Rumisek, Charles E. Wade, Kenneth Kaplan, Carlin V. Okerberg, James H. Corley, Michael J. Barry, John S. Clarke

Research output: Contribution to journalArticle

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Abstract

The influence of early graft surface thromboreactivity on long-term arterial polyester (Dacron) graft patency was investigated with separate ex vivo and in vivo animal models. First, parallel, flow-regulated external aortocaval fistulae were created in five pigs with use of paired 8 mm × 35 cm crimped, warp-knitted, low-profile filamentous velour Dacron tubes: one tube preclotted with autologous blood, the other autoclaved after being soaked in human albumin. Autologous radiolabeled platelets, red cells, and radiolabeled human fibrinogen were injected at initiation of graft flow, with timed graft samples submitted for isotope gamma well-counting. Flow surface accumulation of radiolabeled blood elements was greater on the preclotted graft limb at all time intervals studied, greatest after 5 minutes of flow initiation with RBC accumulation on the preclotted limb 5.19 ± 0.84 (x ± S.E.), platelet accumulation 5.57 ± 1.00, and fibrinogen accumulation 1.82 ± 0.14 times greater than that on the albumin-treated limb. Second, bilateral iliofemoral artery bypass grafts were placed in 12 mongrel dogs using 6 mm × 10 cm externally supported, noncrimped, warp-knitted, low-profile filamentous Dacron tubes. Before implant in each dog, one graft limb was clotted with autologous blood and the other was autoclaved after being soaked in 25% human albumin. Fresh autologous radiolabeled platelets were injected after wound closure in seven of these dogs. Postimplant graft imaging at 24 and 72 hours showed radiolabeled platelet accumulation to be 1.43 ± 0.21 and 2.05 ± 0.18 times greater on the preclotted graft limb. Six of 12 preclotted graft limbs and 7 of 12 albumin-treated graft limbs were patent when animals were killed 5 to 6 months after implant (not significant). Heat-denatured albumin-coated Dacron surfaces have a reduced early thromboreactivity but do not appear to greatly potentiate long-term arterial graft patency.

Original languageEnglish (US)
Pages (from-to)654-661
Number of pages8
JournalSurgery
Volume105
Issue number5
StatePublished - Jan 1 1989

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Transplants
Extremities
Polyethylene Terephthalates
Albumins
Blood Platelets
Dogs
Fibrinogen
Cutaneous Fistula
Polyesters
Isotopes
Swine
Animal Models
Arteries
Hot Temperature
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery

Cite this

Rumisek, J. D., Wade, C. E., Kaplan, K., Okerberg, C. V., Corley, J. H., Barry, M. J., & Clarke, J. S. (1989). The influence of early surface thromboreactivity on long-term arterial graft patency. Surgery, 105(5), 654-661.

The influence of early surface thromboreactivity on long-term arterial graft patency. / Rumisek, John D.; Wade, Charles E.; Kaplan, Kenneth; Okerberg, Carlin V.; Corley, James H.; Barry, Michael J.; Clarke, John S.

In: Surgery, Vol. 105, No. 5, 01.01.1989, p. 654-661.

Research output: Contribution to journalArticle

Rumisek, JD, Wade, CE, Kaplan, K, Okerberg, CV, Corley, JH, Barry, MJ & Clarke, JS 1989, 'The influence of early surface thromboreactivity on long-term arterial graft patency', Surgery, vol. 105, no. 5, pp. 654-661.
Rumisek JD, Wade CE, Kaplan K, Okerberg CV, Corley JH, Barry MJ et al. The influence of early surface thromboreactivity on long-term arterial graft patency. Surgery. 1989 Jan 1;105(5):654-661.
Rumisek, John D. ; Wade, Charles E. ; Kaplan, Kenneth ; Okerberg, Carlin V. ; Corley, James H. ; Barry, Michael J. ; Clarke, John S. / The influence of early surface thromboreactivity on long-term arterial graft patency. In: Surgery. 1989 ; Vol. 105, No. 5. pp. 654-661.
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abstract = "The influence of early graft surface thromboreactivity on long-term arterial polyester (Dacron) graft patency was investigated with separate ex vivo and in vivo animal models. First, parallel, flow-regulated external aortocaval fistulae were created in five pigs with use of paired 8 mm × 35 cm crimped, warp-knitted, low-profile filamentous velour Dacron tubes: one tube preclotted with autologous blood, the other autoclaved after being soaked in human albumin. Autologous radiolabeled platelets, red cells, and radiolabeled human fibrinogen were injected at initiation of graft flow, with timed graft samples submitted for isotope gamma well-counting. Flow surface accumulation of radiolabeled blood elements was greater on the preclotted graft limb at all time intervals studied, greatest after 5 minutes of flow initiation with RBC accumulation on the preclotted limb 5.19 ± 0.84 (x ± S.E.), platelet accumulation 5.57 ± 1.00, and fibrinogen accumulation 1.82 ± 0.14 times greater than that on the albumin-treated limb. Second, bilateral iliofemoral artery bypass grafts were placed in 12 mongrel dogs using 6 mm × 10 cm externally supported, noncrimped, warp-knitted, low-profile filamentous Dacron tubes. Before implant in each dog, one graft limb was clotted with autologous blood and the other was autoclaved after being soaked in 25{\%} human albumin. Fresh autologous radiolabeled platelets were injected after wound closure in seven of these dogs. Postimplant graft imaging at 24 and 72 hours showed radiolabeled platelet accumulation to be 1.43 ± 0.21 and 2.05 ± 0.18 times greater on the preclotted graft limb. Six of 12 preclotted graft limbs and 7 of 12 albumin-treated graft limbs were patent when animals were killed 5 to 6 months after implant (not significant). Heat-denatured albumin-coated Dacron surfaces have a reduced early thromboreactivity but do not appear to greatly potentiate long-term arterial graft patency.",
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