Burches Bobby, Karnicki Krzysztof, Wysokinski Waldemar, McBane Robert D
Section of Hematology Research Mayo Clinic, Rochester, Minnesota 55905, USA.
Thromb Haemost. 2006 Nov;96(5):618-22.
Stenting has become a common intervention for venous occlusive disease. Little is known regarding the composition of venous thrombi complicating stent placement. The optimal design of antithrombotic agents in this setting requires this knowledge. Quantitative immunohistochemistry was undertaken to define the platelet, fibrin(ogen) and leukocyte composition and spatial orientation of venous thrombi following percutaneous iliac stent placement in pigs. Venous stent thrombus size was measured by weight and scintillation detection of autologous (111) In-platelets. Thrombi were divided in segments (cephalad to caudad), sectioned and stained with monoclonal anti-platelet glycoprotein Ib or polyclonal anti-fibrin(ogen) fluorescent antibodies. Thrombus platelet content was 100-fold greater than paired whole blood samples. The caudal-most segments contained platelet-rich aggregates (p < 0.05) with abundant leukocytes (p < 0.0001) relative to more cephalad segments. Platelet and fibrin(ogen) content varied over an eight-fold range between segments but were directly correlated with each other (r = 0.77; p < 0.0001). The platelet co-localization with fibrin(ogen) is consistent with the phospholipid dependence of prothrombin activation. The abundance and caudal distribution of platelet-leukocyte aggregates indicate their preferential accretion from flowing blood early in the genesis of venous stent thrombi. These may represent novel cellular targets for the prevention and treatment of venous thrombosis.
支架置入术已成为静脉闭塞性疾病的常见干预手段。关于支架置入术后并发静脉血栓的组成情况，人们了解甚少。在此情况下，抗血栓药物的最佳设计需要这方面的知识。本研究采用定量免疫组化法来确定猪经皮髂静脉支架置入术后静脉血栓中血小板、纤维蛋白（原）和白细胞的组成以及空间取向。通过称重和对自体（111）铟标记血小板进行闪烁检测来测量静脉支架血栓的大小。将血栓分成节段（头端至尾端），切片并用抗血小板糖蛋白Ib单克隆抗体或抗纤维蛋白（原）多克隆荧光抗体染色。血栓中的血小板含量比配对的全血样本高100倍。相对于头端节段，最尾端节段含有富含血小板的聚集体（p<0.05）以及大量白细胞（p<0.0001）。各节段间血小板和纤维蛋白（原）含量在8倍范围内变化，但彼此直接相关（r = 0.77；p<0.0001）。血小板与纤维蛋白（原）的共定位与凝血酶原激活的磷脂依赖性一致。血小板 - 白细胞聚集体的丰度和尾端分布表明它们在静脉支架血栓形成早期优先从流动血液中聚集。这些可能代表了预防和治疗静脉血栓形成的新细胞靶点。
