ADP-INDUCED P-SELECTIN EXPRESSION ON PLATELETS AS A PREDICTOR OF SUCCESSFUL THROMBOLYSIS

Unlike coronary thrombolysis, the role of platelet activity in the out come of local thrombolytic therapy for peripheral ischaemia is not wel l understood In the present study ten patients undergoing local pulse spray thrombolysis (PST) with recombinant tissue-type plasminogen acti vator (rt-PA), six patients undergoing conventional infusion thromboly sis (CT) with rt-PA and another six patients undergoing arteriography with iopamidol were studied Venous blood samples obtained before and a fter the procedure were analysed using a flow cytometric technique for detection of platelet activation after labelling platelets with VH10, a monoclonal antibody against P-selectin. In the present study no sig nificant differences were observed in P-selectin expression before and after any of the procedures, except that P-selectin expression follow ing ADP stimulation was reduced in patients who had received conventio nal thrombolysis. Unexpectedly, we observed relatively greater P-selec tin expression, particularly after ADP stimulation, both before and fo llowing thrombolysis in ten patients in whom thrombolysis was successf ul compared with six patients in whom thrombolysis was unsuccessful. A DP-induced P-selectin expression on platelets may therefore be a usefu l predictor of outcome of peripheral intra-arterial thrombolysis.