Advertisement

International Journal of Angiology

, Volume 11, Issue 2, pp 73–76 | Cite as

Immediate postoperative thrombocytopenia following elective abdominal aortic anuerysm repair and aortic vascular surgery for occlusive disease

  • Rajesh Y. Satchidanand
  • Gurbinder S. Nandhara
  • Pratap P. Chowdary
  • Anthony B. Woodyer
Original Articles
  • 47 Downloads

Abstract

Ischaemia and reperfusion injury is a major problem in modern day vascular surgery. There is increased platelet adhesiveness and aggregation following aortic vascular surgery. Mortality and morbidity following aortic surgery particularly after ruptured AAA is associated with development of coagulopathy. Platelet count, white cell count, prothrombin time and activated partial thromboplastin time were monitored pre- and post-operatively in 38 patients undergoing elective aortic surgery. All patients had a fall in platelet count and all but 4 patients had a rise in white cell count. Twenty patients (38%) developed thrombocytopenia (platelet count <130×109/L, normal range in our lab 130−140×109/L). The range of changes in platelet count was not significantly related to the type of operation (p=0.3102), type of graft used (p=0.5626) or to blood transfusion (p=0.778). Six patients (16%) had systemic inflammatory response syndrome, of whom three died and two developed chest infections needing prolonged ITU care and antibiotics. These patients had a significant fall in platelet count (p=0.0243). The extent of change in platelet count and white cell count may have a prognostic value.

Keywords

Inflammatory Response Platelet Count Thrombocytopenia Blood Transfusion Vascular Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Barry MC, Kelly C, Burke P, Sheehan S, Redmond HP, Bouchier-Hayes D (1997) Immunological and physiological responses to aortic surgery: Effect of reperfusion on neutrophil and monocyte activation and pulmonary function. Br J Surg 84(4):513–519.Google Scholar
  2. 2.
    Bradbury A, Adam D, Garrioch M, Brittenden J, Gillies T, Ruckley CV (1997) Changes in platelet count, coagulation and fibrinogen associated with elective repair of asymptomatic AAA and aortic reconstruction for occlusive disease. Eur J Vac and Endovasc Surg 13:375–380.Google Scholar
  3. 3.
    Bradbury AW, Bachoo P, Milne AA, Duncan JL (1995) Platelet count and the outcome of operation for ruptured abdominal aneurysm. J Vasc Surg 21(3):484–491.Google Scholar
  4. 4.
    Schmitt BP, Adelman B (1993) Heparin-associated thrombocytopenia: A critical review and pooled analysis. Ame J Med Sci 305(4):208–215.Google Scholar
  5. 5.
    De Mol Van Otterloo JC, Van Bockel JH, Ponfroot ED, Briet E, Brommer EJ, Hermans J, Daha MR (1991) Systemic effects of collagen-impregnated aortoiliac Dacron vascular prostheses on platelet activation and fibrin formation. J Vasc Surg 14(1):59–66.Google Scholar
  6. 6.
    De Mol Van Otterloo JC, Van Bockel JH, Ponfoort ED, Brommer EJ, Hermans J, Daha MR (1992) The effects of aortic reconstruction and collagen impregnation of Dacron protheses on the complement system. J Vasc Surg 16:(5)774–777.Google Scholar
  7. 7.
    Gadaleta D, Fantini GA, Silane MF, Davis JM (1994). Neutrophil Leukotriene generation and pulmonary dysfunction after abdominal aortic aneurysm repair. Surgery 116(5):847–852.Google Scholar
  8. 8.
    Groenveld AB, Raijmakers PG, Rauwerda JA, Hack CE (1997) The inflammatory response to vascular surgery-associated ischaemia and reperfusion in man: effect on postoperative pulmonary function. Eur J Vasc Endovasc Surg 14(5):351–359.Google Scholar
  9. 9.
    Jackson Mr, Gillespie DL, Chang AS, Longenecker EG, Peat RA, Alving BM (1998) The incidence of heparin-induced antibodies in patients undergoing vascular surgery prospective study. J Vasc Surg 28(3):439–445.Google Scholar
  10. 10.
    Odegard A, Lundbom J, Myhre HO, Hatlinghus S, Berg K, Waage A, Bjerve KS, Mollnes TE, Aadahl P, Lie TA, Videm V (2000) The inflammatory response following treatment of abdominal aortic aneurysms comparison between open surgery and endovascular repair. Eur J Vasc Endovasc Surg 19(5):536–544.Google Scholar
  11. 11.
    Raijmakers PG, Groeneveld AB, Rauwerda JA, Schneider AJ, Tuele GJ, Hack CE, Thijs LG (1995) Transient increase in interluekin-8 and pulmonary vascular permeability following aortic surgery. J Respir Crit Care Med 151:698–705.Google Scholar
  12. 12.
    Sukhrev II, Guch AA, Medvedsky EB, Kostylev MV, Kornitskaia AI, Gindich LA, Dominiak AB, Vlaikov GG (1999) Pathophysiology, prophylaxis and treatment of reperfusion syndrome in the surgery of abdominal aorta aneurysm. Klin Kher (8):15–17.Google Scholar
  13. 13.
    Thompson MM, Nasim A, Sayers RD, Thompson J, Smith G, Lune J, Bell PRF (1996) Oxygen free radical and cytokine generation during endovascular and conventional aneurysm repair. Eur J Vasc Endovasc Surg 12:70–75.Google Scholar
  14. 14.
    Toes GJ, van den Dungen JJ, Haan J, Hermans RA, van Oeveren W (1999) Fluorescence labelling to study platelet and leucocyte deposition onto vascular grafts. Biomaterials 20(20):1951–1958.Google Scholar
  15. 15.
    Ward A, McBurney A, Lune J (1994) Evidence for the involvement of oxygen-derived free radicals in ischaemia-reperfusion injury. Free Radic Res 20(1):21–28.Google Scholar

Copyright information

© International College of Angiology, Inc. 2002

Authors and Affiliations

  • Rajesh Y. Satchidanand
    • 1
  • Gurbinder S. Nandhara
    • 1
  • Pratap P. Chowdary
    • 1
  • Anthony B. Woodyer
    • 1
  1. 1.Vascular Unit, Department of SurgeryTameside General HospitalLancsU.K.

Personalised recommendations