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  • 1
    ISSN: 1432-198X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1615-5947
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: p 〈 0.05). The rate of subsequent CABG after leg bypass was very low, 2% at 5 years, 3% at 10 years. The cumulative probability of requiring a subsequent infrainguinal bypass was 27% at 5 years, 32% at 10 years. Of these, 46% were ipsilateral and 54% were contralateral. Considering only subsequent tibial bypasses (where vein might be considered obligatory), the cumulative 5-year rate of subsequent leg bypass was only 13%. Another bypass was most likely to occur within the first 3 years, rarely thereafter. In summary, after primary infrainguinal bypass, additional procedures using vein may arise in ¼ to ⅓ of patients, mostly in the first 3 years. However, only 13% will definitely need vein for tibial bypass in 5 years, and subsequent CABG is uncommon.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1573-742X
    Keywords: ulfated hyaluronic acid derivatives ; platelet aggregation ; platelet activation ; heparin-like
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A number of sulfated hyaluronic acid derivatives (HyalS2.5, HyalS3, and HyalS4) were prepared by sulfation of the -OH groups present on hyaluronic acid and were generically termed HyalSx. The anticoagulant properties of this series of compounds has previously been shown to be good in terms of their whole blood clotting inhibition and factor Xa and thrombin inactivation. The purpose of the present study was to investigate whether the use of these compounds would be beneficial to patients who would normally be given heparin, and to perform some preliminary investigations into their effects on platelets. The three compounds were thus studied by investigating their ability to inhibit von Willebrand factor–dependent platelet agglutination in comparison with unfractionated heparin. Agglutination was determined turbidometrically after the addition of ristocetin to stirred formaldehyde-fixed platelets and was demonstrated to be dependent on the presence of sulfate groups on the polysaccharide chain and correlated with the degree of HyalSx sulfation. Interactions possibly important in low shear environments were investigated by measuring the pharmacological action of the HyalSx on spontaneous platelet activation and aggregate formation by flow cytometry. The data indicate that platelet activation is not correlated with the number of sulfate or hydroxyl groups on HyalSx, suggesting that activation occurs not via electrostatic interactions or H bonding, but via some other mechanism. A differentiation between low and high glycosaminoglycan sulfation densities is observed with respect to platelet aggregation, which is correlated with the number of sulfated groups per disaccharide unit. The ability of HyalSx to inhibit platelet aggregation induced by ADP and thrombin was measured by aggregometry. HyalS4 resisted thrombin stimulation to a similar extent as heparin. All Hyal derivatives, however, were better at inhibiting ADP-induced aggregation than was heparin. We conclude, therefore, that clinical use of HyalSx in place of heparin may be beneficial because ristocetin-dependent agglutination, and therefore resistance to platelet aggregation in high shear environments, in addition to resistance to stimulation by ADP, has been shown to be superior to heparin. Spontaneous platelet activation and aggregation are induced at an overall low level, even at high HyalSx concentrations, and are comparable with that of heparin.
    Type of Medium: Electronic Resource
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