[An experimental study of arterial graft implantation--the effects of an anti-thrombin agent, argatroban, and an anti-platelet agent, clopidogrel (SR 25990 C) on the inner capsule].
The anti-thrombogenicity of argatroban and clopidogrel and the influence of these two agents on coagulation and fibrinolysis were investigated. After the infrarenal abdominal aorta of 21 dogs was replaced with a knitted Dacron prosthesis of 5 mm in internal diameter, the inner capsule of the graft was evaluated by angioscopy and angiography immediately and 1 week, 2 weeks and 1 month after surgery. The graft patency rate in group I (untreated group, n = 8), group II (argatroban group, postoperative infusion of 1 microgram/kg/min for 2 weeks, n = 7) and group III (clopidogrel group, postoperative oral administration of 12.5 mg/kg/day for 1 month, n = 6) was respectively 75%, 86% and 100% after 1 week; 75%, 86% and 100% after 2 weeks; and 50%, 71% and 100% after 1 month. The mean maximum stenosis measured by angioscopy was 31% in group I, 5% in group II and 4% in group III after 1 week; 52%, 23% and 13% after 2 weeks; and 61%, 40% and 9% after 1 month. An increase in thrombin antithrombin III complex (TAT) due to thrombus was observed in group I, but this was prevented in the treated groups. These results suggest that argatroban and clopidogrel are useful anti-thrombogenic agents for obtaining a thin inner capsule after graft implantation, especially in small caliber grafts.
Hanaoka
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Second Department of Surgery, Okayama University Medical School, Japan.
D017546:Angioscopy; D000818:Animals; D000991:Antithrombins / Q000494:pharmacology*; D001012:Aorta, Abdominal / Q000473:pathology / Q000601:surgery; D001120:Arginine / Q000031:analogs & derivatives; D001777:Blood Coagulation / Q000187:drug effects; D001807:Blood Vessel Prosthesis; D000077144:Clopidogrel; D004285:Dogs; D005342:Fibrinolysis / Q000187:drug effects; D006083:Graft Occlusion, Vascular / Q000097:blood / Q000473:pathology / Q000517:prevention & control*; D010875:Pipecolic Acids / Q000494:pharmacology*; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology*; D013449:Sulfonamides; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000494:pharmacology
D000991:Antithrombins; D010875:Pipecolic Acids; D010975:Platelet Aggregation Inhibitors; D013449:Sulfonamides; D001120:Arginine; D000077144:Clopidogrel; C031942:argatroban; D013988:Ticlopidine