Microvenous thrombosis rates following anastomosis with vein grafting and a knotted suture.
An experimental microvenous thrombosis model was developed combining vein grafting in femoral vein defects with exaggerated vessel injuries using a knotted suture in the vessel repair. The rat femoral vein grafts were separately subjected to injuries caused by an anastomosis performed with a suture knotted with eight half-hitches at the distal anastomosis (upstream), the proximal anastomosis (downstream), and both anastomotic sites. These groups were compared to vein grafting done with a standard suture. Vessel patency was assessed at 20 min and 24 hr, and the thrombus component was histologically analyzed at 24 hr after the procedures. One hundred percent of control vein grafts were patent at 24 hr. All experimental groups had significantly decreased patency at 24 hr (P < 0.001). Among the experimental groups, knotted suture anastomoses at both anastomoses produced significantly lower patency (13.3%, P < 0.05) than knotted suture anastomoses at distal anastomoses. Histological analyses of thrombosed grafts showed that a large amount of thrombocyte deposition and inflammatory cells were noted at both anastomotic sites in the vein grafts with a knotted suture at the distal anastomosis and in the grafts with a knotted suture at both anastomoses. Thrombocyte deposition and inflammatory cells were seen only at the site of proximal anastomosis when using a knotted suture at the proximal anastomosis site alone. This study demonstrated that quantified microvenous thrombosis can be produced by exaggerating vessel injuries with a knotted suture in a vein graft model. This thrombosis model can be used to study the effects of antithrombogenic agents.
Division of Plastic & Reconstructive Surgery, Stanford University Medical Center, CA 94305, USA.
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F
Zhang
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Ustüner
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R
Walker
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Buntic
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WC
Lineaweaver
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D001807:Blood Vessel Prosthesis; D005268:Femoral Vein / Q000293:injuries / Q000601:surgery; D006083:Graft Occlusion, Vascular / Q000209:etiology* / Q000473:pathology; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley; D013536:Suture Techniques; D013537:Sutures; D013927:Thrombosis / Q000209:etiology* / Q000473:pathology; D014654:Vascular Patency