Faculty Collaboration Database

Thrombodynamics of microvascular repairs: effects of antithrombotic therapy on platelets and fibrin. J Hand Surg Am 2013 Sep;38(9):1784-9

Date

07/31/2013

Pubmed ID

23891176

DOI

10.1016/j.jhsa.2013.05.033

Scopus ID

2-s2.0-84883188239 (requires institutional sign-in at Scopus site)   16 Citations

Abstract

PURPOSE: To evaluate the hypothesis that platelets and fibrin differentially accrue at microvascular anastomoses in arteries versus veins and under different pharmacologic conditions.

METHODS: We evaluated mouse arterial and venous anastomoses with intravital fluorescence imaging, using fluorophore-labeled platelets and anti-fibrin antibodies to measure the extent of thrombus component development in the intraluminal anastomotic site. We evaluated systemic heparin or eptifibatide (platelet aggregation inhibitor) to determine their relative influences on thrombus composition.

RESULTS: Platelets accumulated rapidly in both arterial and venous repairs, and then fell in number after 10 to 30 minutes of reflow. Fibrin had a relatively steady development over 60 minutes in veins, with a more variable increase in arteries. Heparin reduced platelet accumulation in arteries and fibrin development in veins. Eptifibatide reduced platelets in both arteries and veins and had an apparent effect on lowering the amount of fibrin in veins.

CONCLUSIONS: These findings show that platelets have a rapid, transient response, whereas fibrin has a slower, more sustained accrual in both arterial and venous anastomoses. Furthermore, inhibition of either coagulation or platelet aggregation can influence presumably non-targeted components of thrombosis in vascular repairs of both arteries and veins.

CLINICAL RELEVANCE: Preventing replantation failure using antithrombotic therapies requires a better understanding of the effect of each pharmacologic compound on the various aspects of thrombogenesis.

Author List

Shi G, Meister D, Daley RA, Cooley BC

MESH terms used to index this publication - Major topics in bold

Anastomosis, Surgical
Animals
Fibrin
Fibrinolytic Agents
Male
Mice
Mice, Inbred C57BL
Microsurgery
Peptides
Platelet Aggregation
Replantation
Thrombosis
Vascular Patency