Preventive effect of botulinum toxin A in microanastomotic thrombosis: a rabbit model.
BACKGROUND
Microvascular free tissue transfers play an important role in the reconstruction of body defects. Various aetiologies lead to vascular thrombosis and free-flap failure. In this study, the effects of botulinum toxin A on vessel diameters and prevention of anastomotic thrombosis were studied in a blinded vasospasm model in rabbits.


METHODS
One side of 16 adult rabbit ears was pre-treated with botulinum toxin type A, and normal saline injections were performed as control in the contralateral side. Seven days later, vessel diameters were measured in both the groups; the vessels were then cut and reanastomosed after vasospastic challenge and vessel patencies were evaluated.


RESULTS
Both artery and vein diameters were significantly larger in the botulinum toxin A group (P=0.002 and < 0.001, respectively). The patency rate of arterial and venous anastomosis was significantly higher in the neurotoxin pre-treated group (P=0.038 and 0.003, respectively).


CONCLUSIONS
This study shows that pre-treatment with botulinum toxin type A is associated with a lower rate of arterial and venous thrombosis in rabbit-model microanastomosis. Further studies are necessary to evaluate its ability to decrease vasospasm and thrombosis in free-flap survival of humans.
Fathi
Mehdi
M
Division of Plastic and Reconstructive Surgery, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Fathi
Hamidreza
H
Mazloumi
Mehdi
M
Khalilzadeh
Omid
O
Amanpour
Saeid
S
Meysamie
Alipasha
A
Mashali
Leila
L
Kardar
Mohammad H
MH
D000714:Anastomosis, Surgical; D000818:Animals; D019274:Botulinum Toxins, Type A / Q000494:pharmacology*; D004195:Disease Models, Animal; D011183:Postoperative Complications / Q000517:prevention & control*; D011817:Rabbits; D011897:Random Allocation; D013524:Surgical Flaps / Q000098:blood supply; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*
D019274:Botulinum Toxins, Type A