Platelet and leukocyte activation during aortoiliac angiography and angioplasty

Objective: to evaluate platelet and leukocyte activation during aortoiliac angiography and percutaneous transluminal angioplasty (PTA). Methods: an observational study of 14 patients with aortoiliac atherosclerotic disease, nine of whom underwent PTA. The proportion of fibrinogen-, and P-selectin positive platelets, P-selectin expression on platelets, intraplatelet cGMP and cAMP, CD18 positive granulocytes, CD18 expression on granulocytes, plasma (p)-neopterin, p-TNF alpha and p-interleukin-6 were repeatedly measured in arterial blood during angiography and in venous blood before and after. Results: compared to a previous venous sample, arterial intraplatelet cAMP was increased proximal to the atherosclerotic lesion before contrast infusion and PTA (median 18 [range: 14-22] vs 16 [15-21]pmol/10(9) platelets; p<0.05), and intraplatelet cGMP was increased proximal to the lesion after contrast infusion and PTA (1.2 [0.8-3.9] vs 0.9 [0.6-2.5]pmol/10(9) platelets; p<0.05). Four hours after angiography, both the proportion of P-selectin positive platelets (28 [11-55]%) and platelet P-selectin expression (9 [6-40]) had decreased (p<0.05), from arterial values distal to the lesion before contrast infusion and PTA (57 [24-78]% and 26 [10-83]). Granulocyte CD18 expression was lower during angiography than in a previous venous sample. Conclusions: the results are compatible with platelet but not leukocyte activation during peripheral angiography.