[A clinical and experimental study of the antithrombotic percutaneous cardiopulmonary support using the new antithrombotic coating material].
The antithrombogenicity of the new antithrombogenic coating material "Fluorine-acryl-styrene-urethane-silicone (FASUS) graft-block copolymer" was evaluated by using arerio-arterial (A-A) shunt method in a rabbit and heparinless veno-arterial bypass (VAB) model in a dog. In ex vivo A-A shunt model, FASUS coated group (n = 4) showed significantly longer occlusion times compared with CONTROL group (n = 4) as follows (mean +/- SD): FASUS 109.5 +/- 34.7; CONTROL 3.0 +/- 0.8 minutes. In heparinless VAB model, all tubing materials from the CONTROL group (n = 6) showed major clots, by contrast, no clots were observed in any part of the entire circuits of the FASUS coated group (n = 6) (p < 0.005). The scanning electron microscopic examination revealed thick layers of platelets aggregate and fibrin sheets have firmly adhered to the uncoated surfaces (p < 0.05). In the FASUS coated group, morphologic platelet changes were slight. And we used the cannulas coated by FASUS copolymer in percutaneous cardiopulmonary support (PCPS) with low dose systemic heparinization equipped by heparin coated oxygenator, centrifugal pump and tubing materials. And activated coagulation time was maintained about 150 seconds with or without minimal systemically administered heparin. Consequently, the result was significantly improved (weaning rate 72.2%, long survival rate 33.3%), and hemorrhagic or thromboembolic complications were not observed. These data suggest that FASUS copolymer coating is effective for preventing thrombus formation, and PCPS with low dose systemic heparinization is useful to control postoperative bleeding.
Kawahito
K
K
Department of Cardiovascular Surgery, Omiya Medical Center, Jichi Medical School, Saitama, Japan.
D000368:Aged; D000818:Animals; D004285:Dogs; D005069:Evaluation Studies as Topic; D005260:Female; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D011108:Polymers / Q000494:pharmacology*; D011817:Rabbits; D012828:Silicones / Q000494:pharmacology*; D013927:Thrombosis / Q000517:prevention & control*
D011108:Polymers; D012828:Silicones; C083455:fluorine-acryl-styrene-urethane-silicone copolymer