Effects of enoxaparin, standard heparin, and streptokinase on the patency of anastomoses in severely crushed arteries

被引:46
作者
Chen, LE [1 ]
Seaber, AV [1 ]
Korompilias, AV [1 ]
Urbaniak, JR [1 ]
机构
[1] DUKE UNIV, MED CTR, ORTHOPAED RES LABS, DEPT SURG, DURHAM, NC 27710 USA
关键词
D O I
10.1002/micr.1920161002
中图分类号
R61 [外科手术学];
学科分类号
摘要
The effects of topical irrigation with three antithrombotic agents on the patency of anastomosed arteries following crush injury were examined. Following an impact crush injury with a 25 kg crush load, the femoral arteries of rats were divided and then anastomosed. During anastomoses, the vessel lumina were topically irrigated with saline, streptokinase, standard heparin, or enoxaparin (a low molecular weight heparin). The results were evaluated by patency test and histology up to day 56. The thrombosis rate at days 1 and 7 was statistically lower (P < 0.05) in the standard heparin and the enoxaparin groups than in the other two groups. The difference between the standard heparin and the enoxaparin groups was not statistically significant. Histology at day 1 showed that thrombus in the occluded vessels adhered to the exposed adventitia in the crushed area or the adventitia was covered by fibrin, red blood cells, and platelet mesh in the patent vessels. The results showed that 1) topical irrigation with standard, heparin or enoxaparin solution significantly reduced the thrombosis rate at the anastomosis site of the crushed arteries; and 2) enoxaparin was as effective an antithrombotic agent as standard heparin when topically applied during microvascular anastomoses. (C) 1996 Wiley-Liss, Inc.
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页码:661 / 665
页数:5
相关论文
共 33 条
[1]  
BIEMER E, 1981, INT SURG, V66, P37
[2]   COMPARISON OF LOW-MOLECULAR-WEIGHT HEPARIN VS UNFRACTIONATED HEPARIN IN GYNECOLOGICAL SURGERY .2. REDUCED DOSE OF LOW-MOLECULAR-WEIGHT HEPARIN [J].
BORSTAD, E ;
URDAL, K ;
HANDELAND, G ;
ABILDGAARD, U .
ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, 1992, 71 (06) :471-475
[3]   THE ROLE OF VARIOUS ANTITHROMBOTIC AGENTS IN MICROVASCULAR SURGERY [J].
BUCKLEY, RC ;
DAVIDSON, SF ;
DAS, SK .
BRITISH JOURNAL OF PLASTIC SURGERY, 1994, 47 (01) :20-23
[4]   Thrombosis and thrombolysis in crushed arteries with or without anastomosis: A new microvascular thrombosis model [J].
Chen, LE ;
Seaber, AV ;
Urbaniak, JR .
JOURNAL OF RECONSTRUCTIVE MICROSURGERY, 1996, 12 (01) :31-38
[5]   COMPARISON OF 10-O POLYPROPYLENE AND 10-O NYLON SUTURES IN RAT ARTERIAL ANASTOMOSIS [J].
CHEN, LE ;
SEABER, AV ;
URBANIAK, JR .
MICROSURGERY, 1993, 14 (05) :328-333
[6]   MORPHOLOGICAL AND MORPHOMETRIC ANALYSES OF RAT FEMORAL ARTERIES AFTER CRUSH INJURY [J].
CHEN, LE ;
SEABER, AV ;
GLISSON, RR ;
MIKAT, EM ;
URBANIAK, JR .
MICROSURGERY, 1991, 12 (06) :402-411
[7]   MICROVASCULAR ANASTOMOSES IN GROWING VESSELS - A LONG-TERM EVALUATION OF NONABSORBABLE SUTURE MATERIALS [J].
CHEN, LE ;
SEABER, AV ;
URBANIAK, JR .
JOURNAL OF RECONSTRUCTIVE MICROSURGERY, 1993, 9 (03) :183-189
[8]   USE OF ENOXAPARIN, A LOW-MOLECULAR-WEIGHT HEPARIN, AND UNFRACTIONATED HEPARIN FOR THE PREVENTION OF DEEP VENOUS THROMBOSIS AFTER ELECTIVE HIP-REPLACEMENT - A CLINICAL-TRIAL COMPARING EFFICACY AND SAFETY [J].
COLWELL, CW ;
SPIRO, TE ;
TROWBRIDGE, AA ;
MORRIS, BA ;
KWAAN, HC ;
BLAHA, JD ;
COMEROTA, AJ ;
SKOUTAKIS, VA .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 1994, 76A (01) :3-14
[9]  
Cooley B C, 1983, Microsurgery, V4, P1, DOI 10.1002/micr.1920040105
[10]   MAINTENANCE OF PATENCY AFTER VASCULAR TRAUMA BY TOPICAL IRRIGATION WITH A PEPTIDE HOMOLOGOUS TO THE CARBOXY-TERMINUS OF THE FIBRINOGEN GAMMA CHAIN [J].
COOLEY, BC ;
DOLLINGER, BM ;
MLSNA, JS ;
GOULD, JS .
JOURNAL OF HAND SURGERY-AMERICAN VOLUME, 1992, 17A (06) :1044-1051