Abstract
This study examined the effect of an orally active thromboxane (TXA 2) synthetase inhibitor (TSI) on the patency, TXA 2 production, and platelet accumulation of reversed autogenous vein grafts. Ten dogs received TSI (U-63557A) 10 mg/kg po q8 hr for 6 weeks, beginning 24 hr prior to surgery, while 15 control dogs were untreated. One jugular vein was harvested and stored in 37°C saline for 1 hr to induce mild endothelial injury (stored). Normal and stored jugular vein grafts (8 cm) were then implanted in opposite femoral arteries while 3-cm segments of the same veins were implanted in the carotid arteries. Femoral graft flow was restricted with a 5 Fr distal arterial stenosis and patency determined by arteriography at 1, 2, 4, and 6 weeks. Vein graft endothelial surface TXB 2 production was measured by RIA at graft implantation and in carotid grafts harvested at 1 week. 111In-labeled platelets were given iv 24 hr prior to carotid graft harvest to determine graft-platelet deposition. TSI treatment improved early (1 week) femoral vein graft patency from 63 to 89% ( P < 0.05), a trend that persisted for 6 weeks. Warm saline storage reduced 1-week graft patency from 83 to 63% ( P < 0.05), a difference that decreased with time. TSI treatment resulted in a marked decrease in TXB 2 production, but was not associated with decreased 111In-labeled platelet deposition in carotid vein grafts. Warm saline storage increased graft-platelet deposition which was predominant at the arterial anastomoses. TSI treatment may improve early vein graft patency during the transient period of endothelial injury.
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