APPLICATION OF THROMBIN BASED FIBRIN GLUE AND NON-THROMBIN BASED BATROXOBIN GLUE ON INTACT HUMAN BLOOD-VESSELS - EVIDENCE FOR TRANSMURAL THROMBIN ACTIVITY

An alternative method of uniting small diameter vessels to obtain tiss ue union while limiting the thrombogenic effect of suture placement at a vessel anastomosis involves the use of a thrombin based fibrin glue as a surgical sealant. This investigation addresses whether the in vi tro application of a thrombin based glue (TG), or batroxobin glue (BG) , a non-thrombin based glue made with the snake venom enzyme batroxobi n, alters intravascular platelet deposition (PD) or cleaves blood fibr inogen, as measured by fibrinopeptide A (FPA) production, when the res pective glue is applied to the external surface of an intact human pla cental artery or an artery with an anastomosis. When TG was applied to the adventitial surface of an intact vessel or an anastomosis (n = 7) of control and experimental vessels, there was a significant increase in intraluminal platelet deposition, an effect not realized with BG ( n = 12, intact vessel TG p = 0.01, BG p = 0.66, anastomosis TG p <0.01 , BG p <0.01). Both TG and BG significantly increased FPA levels when human whole blood was perfused through both intact vessels or vessels containing an anastomosis when compared to control vessels (intact ves sel TG and BG p <0.01, anastomosis TG and BG p <0.01). Labelled thromb in studies document the rapid passage of thrombin through an intact ve ssel wall or vessels with an anastomosis when TG was applied to the ad ventitial surface of the vessel. The data suggest that TG and BG are d rug delivery systems for their respective enzymes that either pass thr ough or transfer a message across not only a surgically created anasto mosis, but also an intact vessel wall.