Quantitative evaluation of ibuprofen treatment on thrombogenicity of expanded polytetrafluoroethylene vascular grafts

To evaluate the effect of ibuprofen on graft thrombogenicity and early patency, expanded polytetrafluoroethylene (ePTFE) (Gore-tex) grafts with an inside diameter of 4 mm and length of 5 cm were implanted into the femoral artery in 43 dogs. Autogenous vein bypass was performed on the contralateral side. 111In-labeled platelets were injected into 16 dogs 24 hours prior to operation, and eight of these received 12.5 mg ibuprofen/kg intravenously 15 minutes prior to cross-clamping. The grafts were removed after 3 hours and radioactivity in five segments of the grafts, including both anastomoses, was determined with a gamma-well counter. Of 27 additional dogs, 13 received oral ibuprofen (150 mg three times daily till the time of sacrifice) and 14 served as controls. The grafts were harvested at 5 days and at 30 days and patency was evaluated. At 30 days, thrombus thickness and extent of intimal hyperplasia on the specimens were measured by light microscopy. At 3 hours, radioactivity per unit of weight (counts per minute per gram) of ePTFE graft to vein graft decreased from 8.46 to 1.34 (P less than 0.001) with ibuprofen treatment. The median radioactivity ratio of ePTFE to blood decreased from 11.62 to 0.89 (P less than 0.01). Platelet deposition was reduced in all segments of treated grafts. The median platelet count was 9.43 X 10(6)/mm2 in control and 0.27 X 10(6)/mm2 in treated grafts (P less than 0.01). The patency of vein grafts did not change significantly, whereas the patency of the ePTFE grafts significantly improved in the treated group at 5 days (P = 0.01) and at 30 days (P less than 0.01). These data demonstrate that ibuprofen effectively reduces early platelet deposition and improves patency of ePTFE grafts.