The effects of platelet inhibitors on platelet uptake and restenosis after femoral angioplasty.

OBJECTIVE

To investigate the effects of two platelet inhibitors, aspirin and iloprost, on platelet uptake and restenosis at the site of angioplasty in patients undergoing femoral or popliteal angioplasty.

EXPERIMENTAL

DESIGN

Prospective, open, randomised group comparison.

SETTING

Two university hospitals.

PATIENTS: 43 patients undergoing femoral or popliteal angioplasty were randomised.

INTERVENTIONS: Patients received either aspirin (300 mg/day), iloprost (8 hours/day i.v. infusion) or no antiplatelet medication during angioplasty and on the subsequent two days.

MEASURES: Platelet uptake was measured using 111Indium-labelled platelets. Restenosis was assessed by repeat angiography at 3 months and clinical symptoms up to 12 months.

RESULTS

Median changes in platelet uptake were similar in the three treatment groups, but all platelet radioactivity ratios > 2.0 occurred in the control group. Restenosis at 3 months was observed in 3 control, 5 aspirin and 1 iloprost patient. Further surgical intervention was performed in 3 control and 3 aspirin patients, but in none of the iloprost patients up to 12 months after angioplasty.

CONCLUSIONS

Antiplatelet therapy may prevent large increases in platelet deposition at the angioplasty site, but the link between platelet deposition and restenosis was not substantiated in this study.