title: Desirudin reduces the rate of microvenous thrombosis in a rat model.
abstract: OBJECTIVE
  In an effort to evaluate pharmacologic agents for optimal anticoagulant prophylaxis in patients undergoing free tissue transfer, we evaluated the efficacy of desirudin (Canyon Pharmaceuticals, Hunt Valley, MD), a recombinant hirudin that acts as a direct thrombin inhibitor, using a rat model of microvenous thrombosis.
  
  
  METHODS
  Randomized, blinded study using an in vivo rat model of microvenous failure.
  
  
  METHODS
  Thirty-two rats received either desirudin or saline in a randomized, blinded fashion 30 minutes prior to performance of a standardized thrombogenic procedure on rat femoral veins. Bleeding time, vessel patency, and presence of clot within the anastomosis were subsequently assessed. Appropriate statistical analyses were then performed.
  
  
  RESULTS
  There was a significant increase in vessel patency in rats treated preoperatively with desirudin compared to controls receiving saline (96.9% vs. 53.1%, P < .001). In evaluating patent vessels for non-occluding clot, 41.2% of control rats had non-obstructive clot at the site of anastomosis, versus 3.2% of rats treated with desirudin (P = .002). Bleeding times were longer in desirudin-treated rats than those that received saline (7.17 +/- 3 minutes vs. 5.15 +/- 1.2 minutes, P = .027).
  
  
  CONCLUSIONS
  The use of preoperative desirudin increases the rate of microvascular anastomotic patency, decreases the occurrence of non-occluding clot, and increases bleeding time in an in vivo rat model, indicating potential efficacy in patients undergoing microvascular free tissue transfer.
authors.affiliation: Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts 02114, USA.
authors.forename: Carol M
authors.initials: CM
authors.lastname: Lewis
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Deschler
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D004195:Disease Models, Animal; D005343:Fibrinolytic Agents / Q000494:pharmacology*; D006085:Graft Survival / Q000187:drug effects; D006629:Hirudins / Q000494:pharmacology*; D008297:Male; D008833:Microcirculation / Q000187:drug effects / Q000601:surgery; D008866:Microsurgery; D011300:Preoperative Care; D051381:Rats; D017207:Rats, Sprague-Dawley; D011994:Recombinant Proteins / Q000494:pharmacology; D013524:Surgical Flaps / Q000098:blood supply*; D013927:Thrombosis / Q000517:prevention & control*
chemical_list: D005343:Fibrinolytic Agents; D006629:Hirudins; D011994:Recombinant Proteins; C060225:desirudin