Platelet aggregability after endoscopic intravariceal injection of 5 per cent ethanolamine oleate into oesophageal varices

Platelet aggregability and the coagulative and fibrinolytic systems were examined in 45 patients who underwent endoscopic injection sclerotherapy for oesophageal varices. Five per cent ethanolamine oleate, the sclerosant used, was injected into the oesophageal varices. There were significant increases in the concentrations of fibrinopeptide A, fibrinopeptide B‐β‐15–42 and fibrin degradation products‐E after the sclerotherapy. At 1 h after the sclerotherapy the mean(s.e.m.) platelet aggregation was significantly suppressed to 71·9(4·2) per cent of that before the treatment (P <0·01). There was a gradual recovery within 1 week to the same level seen before the sclerotherapy. Thomboxane B2 and 6‐keto‐prostaglandin F1α, both stable products of thromboxane A2 and prostacyclin respectively, showed significant temporary increases after the sclerotherapy (P <0·01). The peak increase in the level of thromboxane B2 was noted within 1 h after the sclerotherapy and earlier than that for 6‐keto‐prostaglandin F1α. This increased ratio of prostacyclin and thromboxane A2 may be related to the marked limitation in platelet aggregation.

[1]  T. Satake,et al.  Changes of plasma 6-keto-PGF1 alpha and thromboxane B2 levels and platelet aggregation after tourniquet ischemia on the upper limb in normal subjects and patients with ischemic heart disease. , 1982, Japanese circulation journal.

[2]  P. Kubisz,et al.  Demonstration of a Plasmatic Cofactor Different from Fibrinogen Necessary for Platelet Release by ADP and Adrenaline , 1970, Thrombosis and Haemostasis.

[3]  G. Johnston,et al.  Twenty‐five years of injection sclerotherapy for bleeding varices , 1985, The British journal of surgery.

[4]  S. Kitano,et al.  A rapid and relatively safer method of sclerosing esophageal varices utilizing a new transparent tube. , 1987, American journal of surgery.

[5]  M. Kopeć,et al.  Inhibition of Platelet Aggregation by Dialysable Fibrinogen Degradation Products (FDP) , 1970, Thrombosis and Haemostasis.

[6]  P. Frenckner,et al.  New Surgical Treatment of Varicous Veins of the Oesophagus , 1939 .

[7]  M. Blombäck,et al.  Measurement in human blood of fibrinogen/fibrin fragments containing the bβ 15–42 sequence , 1982 .

[8]  R. Omoto,et al.  Systemic dissemination of ethanolamine oleate after injection sclerotherapy for esophageal varices. , 1985, Archives of surgery.

[9]  J. Vane,et al.  An enzyme isolated from arteries transforms prostaglandin endoperoxides to an unstable substance that inhibits platelet aggregation , 1976, Nature.

[10]  H. Shiozaki,et al.  Mechanism of the haemostatic effect of ethanolamine oleate in the injection sclerotherapy for oesophageal varices , 1987, British Journal of Surgery.

[11]  J. Barboriak,et al.  Relationship of Appearance of Adenosine Diphosphate, Fibrin Formation and Platelet Aggregation in the Haemostatic Plug in vivo , 1965, Nature.

[12]  R. Canfield,et al.  Measurement of fibrinopeptide A in human blood. , 1974, The Journal of clinical investigation.

[13]  G. Palareti,et al.  Platelet and blood clotting activation after endoscopic sclerotherapy of oesophageal varices in liver cirrhosis. , 1986, Thrombosis research.

[14]  R. Pugh,et al.  Transection of the oesophagus for bleeding oesophageal varices , 1973, The British journal of surgery.

[15]  E W Salzman,et al.  Inhibition of platelet function by cis-unsaturated fatty acids. , 1984, Blood.

[16]  D. Evans,et al.  Oesophageal varices treated by sclerotherapy: a histopathological study. , 1982, Gut.

[17]  W. Brooks,et al.  Absence of disseminated intravascular coagulation with endoscopic sclerosis of esophageal varices. , 1982, Gastrointestinal endoscopy.

[18]  H. Gjønnaess Cold promoted activation of factor VII. IV. Relation to the coagulation system. , 1972, Thrombosis et diathesis haemorrhagica.

[19]  G. Born,et al.  Aggregation of Blood Platelets by Adenosine Diphosphate and its Reversal , 1962, Nature.

[20]  J. R. O'brien Platelet aggregation , 1962, Journal of clinical pathology.

[21]  W. Collins,et al.  Radioimmunoassay of prostaglandin F2α in peripheral venous plasma from men and women , 1974 .

[22]  G. FitzGerald,et al.  Analysis of prostacyclin and thromboxane biosynthesis in cardiovascular disease. , 1983, Circulation.