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Platelet-monocyte aggregates in patients with chronic venous insufficiency remain elevated following correction of reflux.
Cardiovasc Surg 2002; 10(5):464-9CS

Abstract

INTRODUCTION

An increased number of circulating platelet-monocyte aggregates (PMAs) is present in patients with all clinical classes of chronic venous insufficiency (CVI). The purpose of this study was to determine whether patients with CVI maintain elevated levels of PMAs following complete surgical correction of chronic venous insufficiency.

METHODS

Patients with superficial venous insufficiency and a normal deep venous system documented by duplex scan were included in the study. Venous blood was drawn from a superficial vein in the leg and an antecubital vein prior to vein stripping and again six weeks postoperatively. Control subjects without evidence of venous disease had blood drawn from an antecubital vein. Whole blood flow cytometry was used to analyze the samples for the presence of platelet-monocyte aggregates following incubation with buffer or 0.5 microM adenosine diphosphate (ADP).

RESULTS

Postoperative duplex scanning demonstrated elimination of venous reflux in the superficial venous system and normal deep vein physiology in all nine patients. Preoperatively, patients with CVI had significantly elevated levels of circulating PMAs in both arm and leg samples without stimulation by an agonist compared to controls (15.2+/-1.1 and 14.3+/-1.3 vs 7.4+/-0.3 for controls, p<0.02 for each), and after stimulation by 0.5 microM ADP (33.7+/-4.7 and 34.3+/-5.2 vs 12.5+/-3.8 for controls, p<0.04 for each). There was no significant change in the number of PMAs in either patient arm or leg blood samples six weeks following correction of venous reflux by removal of the diseased veins.

CONCLUSIONS

Complete correction of chronic venous insufficiency did not diminish the elevated circulating levels of platelet-monocyte aggregates. We conclude that the presence of an increased number of PMAs identified in patients with CVI is not secondary to the presence of venous reflux, but may be involved with the primary etiology of chronic venous insufficiency. This finding also suggests that a stimulus other than venous hypertension may be important in triggering the leukocyte activation seen in patients with chronic venous disease.

Authors+Show Affiliations

Division of Vascular Surgery and the Center for Platelet Function Studies, The University of Massachusetts Medical School, 55 Lake Avenue, North Worcester 01655, USA. RohrerM@ummhc.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12379404

Citation

Rohrer, Michael J., et al. "Platelet-monocyte Aggregates in Patients With Chronic Venous Insufficiency Remain Elevated Following Correction of Reflux." Cardiovascular Surgery (London, England), vol. 10, no. 5, 2002, pp. 464-9.
Rohrer MJ, Claytor RB, Garnette CS, et al. Platelet-monocyte aggregates in patients with chronic venous insufficiency remain elevated following correction of reflux. Cardiovasc Surg. 2002;10(5):464-9.
Rohrer, M. J., Claytor, R. B., Garnette, C. S., Powell, C. C., Barnard, M. R., Furman, M. I., & Michelson, A. D. (2002). Platelet-monocyte aggregates in patients with chronic venous insufficiency remain elevated following correction of reflux. Cardiovascular Surgery (London, England), 10(5), pp. 464-9.
Rohrer MJ, et al. Platelet-monocyte Aggregates in Patients With Chronic Venous Insufficiency Remain Elevated Following Correction of Reflux. Cardiovasc Surg. 2002;10(5):464-9. PubMed PMID: 12379404.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Platelet-monocyte aggregates in patients with chronic venous insufficiency remain elevated following correction of reflux. AU - Rohrer,Michael J, AU - Claytor,R Brannon, AU - Garnette,Charles S C, AU - Powell,Craig C, AU - Barnard,Marc R, AU - Furman,Mark I, AU - Michelson,Alan D, PY - 2002/10/16/pubmed PY - 2003/2/25/medline PY - 2002/10/16/entrez SP - 464 EP - 9 JF - Cardiovascular surgery (London, England) JO - Cardiovasc Surg VL - 10 IS - 5 N2 - INTRODUCTION: An increased number of circulating platelet-monocyte aggregates (PMAs) is present in patients with all clinical classes of chronic venous insufficiency (CVI). The purpose of this study was to determine whether patients with CVI maintain elevated levels of PMAs following complete surgical correction of chronic venous insufficiency. METHODS: Patients with superficial venous insufficiency and a normal deep venous system documented by duplex scan were included in the study. Venous blood was drawn from a superficial vein in the leg and an antecubital vein prior to vein stripping and again six weeks postoperatively. Control subjects without evidence of venous disease had blood drawn from an antecubital vein. Whole blood flow cytometry was used to analyze the samples for the presence of platelet-monocyte aggregates following incubation with buffer or 0.5 microM adenosine diphosphate (ADP). RESULTS: Postoperative duplex scanning demonstrated elimination of venous reflux in the superficial venous system and normal deep vein physiology in all nine patients. Preoperatively, patients with CVI had significantly elevated levels of circulating PMAs in both arm and leg samples without stimulation by an agonist compared to controls (15.2+/-1.1 and 14.3+/-1.3 vs 7.4+/-0.3 for controls, p<0.02 for each), and after stimulation by 0.5 microM ADP (33.7+/-4.7 and 34.3+/-5.2 vs 12.5+/-3.8 for controls, p<0.04 for each). There was no significant change in the number of PMAs in either patient arm or leg blood samples six weeks following correction of venous reflux by removal of the diseased veins. CONCLUSIONS: Complete correction of chronic venous insufficiency did not diminish the elevated circulating levels of platelet-monocyte aggregates. We conclude that the presence of an increased number of PMAs identified in patients with CVI is not secondary to the presence of venous reflux, but may be involved with the primary etiology of chronic venous insufficiency. This finding also suggests that a stimulus other than venous hypertension may be important in triggering the leukocyte activation seen in patients with chronic venous disease. SN - 0967-2109 UR - https://www.unboundmedicine.com/medline/citation/12379404/Platelet_monocyte_aggregates_in_patients_with_chronic_venous_insufficiency_remain_elevated_following_correction_of_reflux_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0967210902000492 DB - PRIME DP - Unbound Medicine ER -