EFFECTS OF ENOXAPARIN, STANDARD HEPARIN, AND STREPTOKINASE ON THE PATENCY OF ANASTOMOSES IN SEVERELY CRUSHED ARTERIES

The effects of topical irrigation with three antithrombotic agents on the patency of anastomosed arteries following crush injury were examin ed. Following an impact crush injury with a 25 kg crush load, the femo ral arteries of rats were divided and then anastomosed. During anastom oses, the vessel lumina were topically irrigated with saline, streptok inase, standard heparin, or enoxaparin (a low molecular weight heparin ). The results were evaluated by patency test and histology up to day 56. The thrombosis rate at days 1 and 7 was statistically lower (P < 0 .05) in the standard heparin and the enoxaparin groups than in the oth er two groups. The difference between the standard heparin and the eno xaparin groups was not statistically significant. Histology at day 1 s howed that thrombus in the occluded vessels adhered to the exposed adv entitia in the crushed area or the adventitia was covered by fibrin, r ed blood cells, and platelet mesh in the patent vessels. The results s howed that 1) topical irrigation with standard, heparin or enoxaparin solution significantly reduced the thrombosis rate at the anastomosis site of the crushed arteries; and 2) enoxaparin was as effective an an tithrombotic agent as standard heparin when topically applied during m icrovascular anastomoses. (C) 1996 Wiley-Liss, Inc.