The use of antithrombotic therapies in reducing synthetic small-diameter vascular graft thrombosis.
BACKGROUND
Thrombosis of synthetic small-diameter bypass grafts remains a major problem. The aim of this article is to review the antithrombotic strategies that have been used in an attempt to reduce graft thrombogenicity.


METHODS
A PubMed/MEDLINE search was performed using the search terms "vascular graft thrombosis," "small-diameter graft thrombosis," "synthetic graft thrombosis" combined with "antithrombotic," "antiplatelet," "anticoagulant," "Dacron," "PTFE," and "polyurethane."


RESULTS
The majority of studies on antithrombotic therapies have used either in vitro models or in vivo animal experiments. Many of the therapies used in these settings do show antithrombotic efficacy against synthetic graft materials. There is however, a distinct lack of human in vivo studies to further delineate the performance and limitations of therapies displaying good antithrombotic characteristics.


CONCLUSIONS
Very few antithrombotic therapies have translated into clinical use. More human in vivo studies are required to assess the efficacy and safety of such therapies.
Leeds Vascular Institute, Leeds General Infirmary, Leeds, Yorkshire, UK. mtatterton@doctors.org.uk
Mark
M
Tatterton
Stacy-Paul
SP
Wilshaw
Eileen
E
Ingham
Shervanthi
S
Homer-Vanniasinkam
D000818:Animals; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015316:Genetic Therapy; D006083:Graft Occlusion, Vascular / Q000188:drug therapy* / Q000209:etiology / Q000235:genetics; D006801:Humans; D061214:Patient Safety; D011474:Prosthesis Design; D018570:Risk Assessment; D012307:Risk Factors; D013927:Thrombosis / Q000188:drug therapy* / Q000209:etiology / Q000235:genetics; D016896:Treatment Outcome
D005343:Fibrinolytic Agents