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Influence of anatomical location on arterial thrombosis
Krzysztof Karnicki1, Erzsebet Komorowicz, David N Fass
1Division of Cardiovascular Medicine, Mayo Clinic and Foundation for Education and Research, Rochester, MN 55905, USA.
Insights
Arterial location significantly impacts thrombosis risk following injury. Hemodynamics, not the artery type, dictate platelet deposition, highlighting regional differences in arterial thrombogenicity.
Area of Science:
- Cardiovascular Biology
- Hemodynamics
- Thrombosis Research
Background:
- Atherosclerosis is a systemic arterial disease.
- Acute thrombotic arterial occlusion distribution is uneven.
- Regional variations in arterial thrombogenicity are not fully understood.
Purpose of the Study:
- To investigate intra-individual regional differences in arterial thrombogenicity.
- To assess the influence of hemodynamics on platelet deposition after arterial injury.
Main Methods:
- Comparison of indium-111-platelet deposition in porcine carotid and femoral arteries post-crush injury.
- Arterial transposition experiments to evaluate the impact of anatomical location on thrombogenicity.
- In vitro studies using high-shear flow chambers to assess platelet deposition on arterial substrates.
Main Results:
- Platelet deposition was over 3-fold higher in carotid arteries compared to femoral arteries under native flow conditions.
- Transposing arteries to different locations altered platelet deposition patterns to match the new site's hemodynamics.
- In flow chambers, carotid and femoral arterial substrates showed similar platelet deposition, independent of thrombin.
Conclusions:
- Regional hemodynamic differences, rather than intrinsic arterial properties, significantly influence thrombosis following deep arterial injury.
- Arterial thrombogenicity is largely determined by the local hemodynamic environment.
- Understanding these hemodynamic influences is crucial for managing arterial thrombosis.
Abstract:
Atherosclerosis manifests as a systemic disease with near global involvement of the named segments of the arterial tree. Acute thrombotic arterial occlusion, however, is not equally distributed. To evaluate intra-individual regional differences in arterial thrombogenicity, we compared (111)In-platelet deposition in porcine carotid and femoral arteries after a standardized crush injury. Within the unidirectional flow conditions of elastic carotid arteries, platelet deposition was more than 3-fold higher compared with predominantly muscular femoral arteries with triphasic arterial flow. To determine the influence of rheology on platelet deposition after crush injury, carotid arteries were transplanted into the femoral position and compared with the paired native carotid and femoral arteries. Similarly, femoral arteries transposed to the carotid position were compared with the paired native carotid artery. In each of these experiments, arterial transposition to a new anatomic location imparts a predilection for platelet deposition indigenous to the new location. In the controlled environment of two high-shear thrombin-independent and -dependent flow chambers, porcine carotid and femoral arterial substrates were indistinguishable from one another with respect to platelet deposition. Regional differences in arterial hemodynamics may account for substantial differences in thrombosis arising from deep arterial injury.