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      Thrombogenicity of the Human Arterial Wall after Interventional Thermal Injury

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          Abstract

          Thermal injury has been shown to reduce platelet adhesion (PA) in vitro but not in vivo. The controversy may be based on the mode of thermal injury, the anticoagulation regimen, or species differences. Human and rabbit arteries were dilated by a radio-frequency (RF)-heated balloon (RF dilation) or by immersion in heated buffer. The artery segments were perfused in an annular perfusion chamber with blood anticoagulant by citrate or heparin (37°C, 5 min, shear rate: 1,300 s<sup>–1</sup>). To determine PA to deep wall layers, 6-µm cross-sections of heated arteries were perfused in a rectangular perfusion chamber (37 °C, 5 min, 1,300 s<sup>–1</sup>)- After RF dilation of human arteries at 55 and 90 °C, subendothelical PA (citrated blood) decreased from 28.9% at 37°C to 6.8%, and increased to 39.6%, respectively (in both cases p < 0.05). Heparin anticoagulation resulted in subendothelial fibrin deposition that was equal after 37 and 90°C, and decreased after 55°C. Heating of cross-sections of atherosclerotic coronary arteries to 55 and 90°C, showed increased and decreased PA, respectively, to the intima and media. No effect was observed on the highly reactive adventitia and atherosclerotic plaque. We conclude that thermal balloon angioplasty at 90°C reduces PA to the arterial subendothelium, but not to the adventitia or the atherosclerotic plaque. As thermal balloon angioplasty in patients will always produce a region with increased PA at 55°C and as heparin anticoagulation permits fibrin deposition that is not affected by heat, it is unlikely that thermal balloon angioplasty alone will reduce thrombotic complications.

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          Author and article information

          Journal
          JVR
          J Vasc Res
          10.1159/issn.1018-1172
          Journal of Vascular Research
          S. Karger AG
          1018-1172
          1423-0135
          1996
          1996
          24 September 2008
          : 33
          : 2
          : 156-163
          Affiliations
          Departments of aCardiology, and bHematology, University Hospital Utrecht, The Netherlands
          Article
          159144 J Vasc Res 1996;33:156–163
          10.1159/000159144
          8630349
          © 1996 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 8
          Categories
          Research Paper

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