Cilostazol effectively reduces the decrease of flow volume in a thrombotic anastomosis model in a rat: a novel application of ultrasonography for evaluation.
The purpose of this study was to investigate the efficacy of cilostazol for prevention of thrombosis in microsurgical anastomosis. We used not only a patency test, but also ultrasonography to evaluate the blood flow volume (FV) more accurately and objectivity. In addition, we evaluated the accuracy and sensitivity of the patency test. Thrombogenic anastomoses were performed on rat external iliac arteries. Forty-six rats were randomly allocated into the following 5 experimental groups: negative control, without any surgery and medication; control, received distilled water orally; group A, received aspirin orally; group B, received cilostazol orally; and group C, received aspirin and cilostazol orally 3 hours before a thrombogenic artery anastomosis. The artery was evaluated by FV using ultrasonography and a patency test 10, 30, and 120 minutes after clamp removal. The FV in group C was significantly larger than the control group 30 minutes after clamp removal. The FVs in groups A, B, and C were significantly larger than the control group 120 minutes after clamp removal. The FV decreased in all groups with time. The patency rate between the control group and group C 120 minutes after clamp removal was significantly different. There were 8 false negatives in a total of 114 patency tests. The total accuracy and sensitivity of the patency test were 93.0% and 92.7%, respectively. Cilostazol plus aspirin therapy is recommended for reducing thrombosis and increasing FV without increasing the risk of bleeding during microsurgery. The patency test cannot evaluate the state of the anastomotic vessels accurately and objectively.
Department of Internal Medicine, School of Medicine, Institute for Medical Genetics, Dongsan Medical Center, Keimyung University, Daegu, Republic of Korea.
Sang-Hyon
SH
Kim
Hyuk Won
HW
Chang
Tae Hyun
TH
Choi
Jun Hyung
JH
Kim
Daegu
D
Son
Kihwan
K
Han
So Young
SY
Lee
Jungbin
J
Park
Euy-Hoon
EH
Suh
Sung-Hwan
SH
Park
D000714:Anastomosis, Surgical / Q000009:adverse effects; D000818:Animals; D000077407:Cilostazol; D004195:Disease Models, Animal; D007083:Iliac Artery / Q000000981:diagnostic imaging*; D008297:Male; D008866:Microsurgery; D051381:Rats; D017207:Rats, Sprague-Dawley; D013777:Tetrazoles / Q000494:pharmacology / Q000627:therapeutic use*; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D014463:Ultrasonography; D014654:Vascular Patency / Q000528:radiation effects; D014665:Vasodilator Agents / Q000494:pharmacology / Q000627:therapeutic use*
D013777:Tetrazoles; D014665:Vasodilator Agents; D000077407:Cilostazol