Platelet and oxygen radicals in chronic arterial occlusion of the extremities with special reference to changes after arterial reconstruction and hyperbaric oxygenation

Abstract

The authors studied changes in platelets and oxygen radicals after arterial reconstruction or hyperbaric oxygenation (HBO) in 41 patients with chronic arterial occlusion of the extremities who were treated in their department. The patients ranged in age from twenty-three to seventy-nine years, with a mean of 61.3 years. Twenty-nine patients had arteriosclerosis obliterans, and 12 had Buerger's disease. Arterial reconstruction was performed in 29, and HBO was used in 12. The parameters measured were platelet count, β-thromboglobulin (βTG), platelet factor 4 (PF4), white blood cell (WBC) count lipid peroxide, and superoxide dismutase (SOD). Blood samples were collected from the cubital vein of the arm without arterial occlusion. Determinations were made before surgery, three days after surgery, and at discharge from hospital in the group treated by arterial reconstruction; and before HBO, immediately after the first HBO, and on the day after the final HBO in the group treated by HBO.

On admission, the patient's mean levels of βTG and PF4 were as high as 67.8 ng/mL and 28.7 ng/mL, respectively. In the arterial reconstruction group, PF4 was significantly lower and WBC count was significantly higher three days after surgery as compared with those before arterial reconstruction. The platelet count was significantly higher and PF4 was significantly lower at discharge as compared with those before reconstruction. On the other hand, there were no HBO-related changes in platelet count, βTG, PF4, WBC count, lipid peroxide, or SOD. Platelet activation in patients with chronic arterial occlusion was suppressed by arterial reconstruction.