Platelet deposition on vascular grafts. The accuracy of in vivo quantitation and the significance of in vivo platelet reactivity.

An in vivo platelet imaging system utilizing indium-111-labeled platelets and technetium-99m-labeled red cells was used to serially study and compare platelet deposition on autologous external jugular vein grafts, autologous arterial grafts, polytetrafluoroethylene (Gore-tex) and two Dacron (Meadox and USCI) small diameter (4mm) vascular grafts implanted end-to-end in canine carotid and femoral arteries. This method of quantitating platelet deposition was validated by correlating deposition measured in vivo with deposition measured directly on explanted grafts (r = 0.94, p less than 0.01). Platelet accumulation on all grafts was greatest immediately after implantation and declined over time. None of the artery or vein grafts thrombosed, and they had the lowest level of platelet deposition at all times. Platelet deposition on Gore-tex grafts was significantly less than on USCI Dacron grafts from 24 hours to 1 month after implantation. There was no statistical difference in 1-month patency among the synthetic graft groups. Synthetic grafts that thrombosed during the first month accumulated significantly more platelets immediately after operation than did those grafts that remained patent. Patent Dacron grafts with low levels of platelet deposition had less thrombotic debris at explantation on the luminal surface than did those grafts with high levels of platelet deposition. Differences in initial platelet deposition appeared to be more a function of platelet reactivity within each dog rather than the material used in graft construction.