Early postoperative changes in hematological, erythrocyte aggregation and blood coagulation parameters after unilateral implantation of polytetrafluoroethylene vascular graft in the femoral artery of beagle dogs

PURPOSE: The failure of small-caliber vascular grafts still means a serious problem. Concerning the early postoperative complications we aimed to investigate the hemostaseological and hemorheological aspects of this issue in a canine model. METHODS: In the Control group only anesthesia was induced. In the Grafted group under general anesthesia a 3.5-cm segment was resected unilaterally from the femoral artery and replaced with a PTFE graft (diameter: 3 mm). On the 1st-3rd-5th-7th and 14th postoperative days the skin temperature of both hind limbs was measured, and blood sampling occurred for hematological, hemostaseological and hemorheological tests. RESULTS: The skin temperature of the operated versus intact limbs did not differ. In the Grafted group leukocyte count was elevated by the 1st postoperative day, while platelet count increased over the entire follow-up period. Fibrinogen concentration rose on the 1st-5th days, activated partial thromboplastin time increased on the 3rd-7th days. Erythrocyte aggregation was enhanced significantly on the 1st-5th days. In specimens taken on the 14th day, histologically we found matured thrombus narrowing the graft lumen. CONCLUSIONS: Small-caliber PTFE graft implantation into the femoral artery caused significant changes in several hemostaseological and hemorheological parameters. However, better clarifying the factors leading to early thrombosis of these grafts needs further studies. .

Changes in erythrocyte aggregation and deformability in diabetes mellitus: a brief review.

Diabetes mellitus (DM) is a metabolic disorder characterized by varying or persistent hyperglycemia either due to insufficient production of insulin by pancreas or improper utilization of the glucose. Erythrocytes remain in hyperglycemic environment throughout their life span and thus are subjected to series of compositional changes, which in turn affect their flow properties through alteration of deformation at individual level and aggregation at collective level. This brief review summarizes the changes in biochemical parameters primarily contributing to the erythrocyte deformability and aggregation as measured by various techniques, of blood samples obtained from diabetic subjects. The significant changes in erythrocyte aggregation and deformability, in comparison with that of control subjects show the relevance of these measurements. These changes are further supported by in vivo observations of blood flow through microvessels. Finally the relevance of these in combination with other clinical parameters is suggested.

Comparison study between the effect of static and alternating magnetic field on Erythrocytes aggregation

The aim of the present study is to show the effect of static and alternating magnetic field on erythrocytes aggregation rate and size. A magnetic coil with iron core was constructed in order to give static magnetic field of intensity from 0.9 to 14 mT, and alternating magnetic field of intensity from 1.5 to 10 mT. The aggregation data are obtained by using online laser transmission technique which was built on the magnetic coil. The analysis shows that the erythrocytes aggregation rate index [EARl] and erythrocytes aggregation size index [EASI] were altered by the magnetic field. There are a strong correlation between the values of static and alternating magnetic field with both EARl and EAST

RBC aggregation: laboratory data and models.

The reversible aggregation of red blood cells (RBC) into linear and three-dimensional structures continues to be of basic science and clinical interest: RBC aggregation affects low shear blood viscosity and microvascular flow dynamics, and can be markedly enhanced in several clinical states. Until fairly recently, most research efforts were focused on relations between suspending medium composition (i.e., protein levels, polymer type and concentration) and aggregate formation. However, there is now an increasing amount of experimental evidence indicating that RBC cellular properties can markedly affect aggregation, with the term "RBC aggregability" coined to describe the cell's intrinsic tendency to aggregate. Variations of aggregability can be large, with some changes of aggregation substantially greater than those resulting from pathologic states. The present review provides a brief overview of this topic, and includes such areas as donor-to-donor variations, polymer-plasma correlations, effects of RBC age, effects of enzymatic treatment, and current developments related to the mechanisms involved in RBC aggregation.

Aplicación de una cámara de flujo para el análisis de la aglutinación eritrocitaria mediada por anticuerpos monoclonales / Application of the flow chamber technique to the analysis of the erythrocyte agglutination mediated by monoclonal antibodies

El conocimiento de la energía involucrada en las interacciones célula-célula tiene importantes implicaciones en las ciencias biológicas y médicas. Los glóbulos rojos se adhieren entre si cuando macromoléculas específicas o no específicas (aglutininas) enlazan células adyacentes de manera irreversible o reversible. La técnica de la cámara de flujo fue utilizada para evaluar la afinidad de un anticuerpo monoclonal analizando la disociación de un doblete (dos células aglutinadas por el anticuerpo) determinando la energía de adhesión. Esta técnica permite aplicar una tensión de corte uniforme paralela a la interfase de adhesión de un aglutinado de dos células fijado sobre la superficie inferior de un microcanal. La tensión produce el desprendimiento progresivo de la célula superior del doblete. La observación microscópica de la separación producida en el aglutinado aislado y la obtención de imágenes secuenciales con una cámara CCD (Charged Coupled Device), permite determinar la relación entre la tensión de corte aplicada (sigma) y el porcentaje de separación de las células del doblete. A partir de estos resultados calculamos la energía de disociación por unidad de área membranal adherida(gamma d), valor igual a 8.92 x 10 elevado a -19 N.cm por moléculas de anticuerpo. Del análisis de los resultados, se concluye que la tensión de corte necesaria para disociar el doblete es proporcional a la densidad superficial de moléculas de anticuerpo y a la densidad antigénica de los eritrocitos.

Evaluación de alteraciones hemorreológicas en pacientes hipertensos / Hemorheological alterations in hypertensive patients

El objetivo de este trabajo fue investigar el perfil de viscosidad sanguínea y evaluar la influencia de factores plasmáticos ( fibrinógeno) y celulares ( agregación eritrocitaria ) en un grupo de pacientes hipertensos comparados con un grupo de paciente normotensos. Se trabajó con sangre anticoagulada de pacientes hipertensos no diabéticos (n=3) e indivíduos sanos (n=40). La viscosidad plasmática y de sangre entera se determinaron con un viscosímetro cono-plato. La agregación eritrocitaria se estudió por observación microscopia de los agregados y cuantificación a través de un parâmetro de forma denominado ASP ( Aggregation Shape Parameter), definido como la relación de área proyectada respecto al perímetro. El fibrinógeno se determino con un coagulómetro por el método de Clauss. Los valores de viscosidad de sangre entera resultaron significativamente aumentados en los pacientes hipertensos respecto de los normales para todas las velicidades estudiadas. Los valores de viscosidad plasmática solo presentaron diferencia significativas a bajas velocidades de corte (1.15 a 11.56 seg •1) . Los pacientes hipertensos presentaron agregados amorfos e irregulares, lo que se refleja en los valores alterados de ASP, significativamente mayores (p<0.001) en paciente hipertensos (0.69± 0.11) respecto de los indivíduos normales ( 0.25± 0.12). Los valores de fibrinógeno resultaron ligeramente superiores en los pacientes hipertensos respecto del grupo control (p< 0.01). Numerosos parámetros hemorreológicos juegan un papel importante en la patogénesis de la hipertensión. Entre estos factores hemorreológicos, valores parâmetros podrían estar en la hipertensión ( hematrocito, fibrinógeno plasmático, deformabilidad y agragación eritrocitaria , viscosidad sanguínea y plasmática). En este trabajo, se pudo demostrar anormalidades en la agregación eritrocitaria, detectada por los valores de ASP que podría estar involucrado en las complicaciones vasculares de la hipertensión.

Haemorheological behaviour of erythrocytes & risk factor profile in patients suffering from Waldenström's macroglobulinaemia.

The plasma viscosity, haematocrit, and erythrocyte aggregation and deformability of blood samples of patients of Waldenström's macroglobulinaemia were measured by capillary viscometer, microcentrifuge, Myrenne aggregometer and filtrometer respectively and correlated with the serum IgM concentrations. The observed increase in plasma viscosity and erythrocyte aggregation and decrease in their deformability were attributed to the increase in the concentration of IgM. Haematocrit was also decreased compared to normal subjects. Based on these parameters a haemorheological risk factor profile was developed and an overall risk factor calculated. An increase in the risk factor in these patients was observed. The haemorheological profile and the calculated risk factors not only help in establishing the inter-relationship of these parameters in the disease state but also to evaluate the severity of the disease.