Antithrombotic potencies of enoxaparin in microvascular surgery: influence of dose and administration methods on patency rate of crushed arterial anastomoses.
This study evaluated the influence of the dose and administration methods of enoxaparin, a low-molecular-weight heparin, on the patency rate of crushed rat femoral arteries following anastomosis. An impact crush with a 25-kg magnitude was applied to a 2-mm segment of 100 rat femoral arteries, followed by anastomosis. The arteries were divided into five groups: group 1 received systemic enoxaparin alone with a relatively high dose (45 IU) twice a day for 3 days; groups 2 and 3 received topical irrigation with a lower (15 IU/mL) concentration and a higher (45 IU/mL) concentration, respectively; group 4 received systemic and topical application at a lower (15 IU) dose and concentration (15 IU/mL); and group 5 received systemic and topical application at a higher (45 IU) dose and concentration (45 IU/mL). The results of this study demonstrate the following: (1) topical irrigation with enoxaparin at a concentration of 45 IU/mL-three times higher than that recommended for clinical use adjusted by body weight (15 IU/mL)-is effective for antithrombotic action; (2) a combination of systemic and local application does not offer additional benefit in the patency rate when compared to local irrigation alone; (3) systemic administration alone does not prevent thrombus formation; and (4) enoxaparin is potentially useful to enhance the patency rate in compromised microvessels.
Korompilias
A V
AV
Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
Chen
L E
LE
Seaber
A V
AV
Urbaniak
J R
JR
D000287:Administration, Topical; D000714:Anastomosis, Surgical; D000818:Animals; D000925:Anticoagulants / Q000008:administration & dosage*; D004195:Disease Models, Animal; D004305:Dose-Response Relationship, Drug; D004353:Drug Evaluation, Preclinical; D017984:Enoxaparin / Q000008:administration & dosage*; D005263:Femoral Artery / Q000601:surgery*; D007262:Infusions, Intravenous; D008866:Microsurgery / Q000379:methods*; D009409:Nerve Crush; D051381:Rats; D017207:Rats, Sprague-Dawley; D007507:Therapeutic Irrigation; D013927:Thrombosis / Q000517:prevention & control; D014654:Vascular Patency / Q000187:drug effects*
D000925:Anticoagulants; D017984:Enoxaparin