ABSTRACT
This paper presents early experience with a primate model for the noninvasive study of the interaction of circulating platelets with healing arterial prostheses. These experiments demonstrate that baboon platelets can be isolated and labeled with 111Indium with high efficiency using a sterile technique. Platelets subjected to this process have a linear life span similar to that of 51Chromium-labeled baboon platelets. The high energy gamma emission of 111Indium oxine allows for external scanning using a standard gamma camera. The small quantity of 111Indium-labeled platelets in the region of the graft can be discriminated from the surrounding blood vessel and quantitated by gamma camera imaging and computer analysis. There was a significant increase in the platelet deposition on prosthetic surfaces observed 5--48 hours after graft implantation and injection of 111Indium-labeled autologous platelets.
Subject(s)
Blood Vessel Prosthesis , Platelet Aggregation , Polyethylene Terephthalates , Animals , Femoral Artery/surgery , Haplorhini , Indium , Male , Papio , Radioisotopes , Wound HealingABSTRACT
A review was performed of 114 patients with symptoms of vertebrobasilar insufficiency (VBI) alone, or in combination with carotid territory transient ischemic attacks or carotid territory completed stroke (cCS) with follow-up extending to ten years. The most frequent symptoms of VBI were visual changes (50%), dizziness (31%), and syncope (30%). Patients with symptoms of VBI and arteriographic evidence of intracranial disease, regardless of stump pressure, are at high risk for cerebral ischemia during endarterectomy. At late follow-up, ranging from one to ten years, 63% of the patients were alive; 88% were asymptomatic. Causes of death were mainly cardiac (44%) and stroke (36%), but patients with symptoms of VBI and cCS died earlier and from a second cerebrovascular accident. When a correct preoperative diagnosis was established, carotid endarterectomy produced relief of symptoms in 90% of the patients.
