[Vascular spasms in microsurgery].

Abstract

Human arteries and veins contract with hypoxia and deprivation of substrate provoked by increasing calcium inflow into the cell and reduced energy. Such spasm may be eliminated by phosphoenolpyruvate which loads up the cell's energy, blocking glycogen reduction at the same time. Reperfusion will then guarantee a sufficient energy stroke. Therapy should pursue the following steps: 1. Phosphoenolpyruvate infusion (1 X 10(-6) up to 1 X 10(-3) gm/ml in tyrodes solution pH 7.3) into the arterial branch, proximal and distal to the injury. 2. Subsequent treatment with vasodilating drugs and rheologically active substances. 3. Failed therapy after more than three hours warm ischemia could be due to autolytic processes and requires resection of the affected vessel. 4. The imbalance of the thrombolytic system with the so-called no reflow phenomenon could be due to a plasminogen activator's inhibitor released during hypoxia. Such cases may reasonably be treated by urokinase or by streptokinase plasminogen complex.

• Authors: H P Bruch, M Hörl, U Lanz, B Bauer, J Epping
• Journal: Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V... (Handchir Mikrochir Plast Chir) Vol. 19 Issue 4 Pg. 186-90 (Jul 1987) ISSN: 0722-1819 [Print] Germany
• Vernacular Title: Gefässspasmen in der Mikrochirurgie.
• PMID: 3623268 (Publication Type: English Abstract, Journal Article)

Chemical References

• Phosphoenolpyruvate
• Adenosine Triphosphate

Topics

• Adenosine Triphosphate (pharmacology)
• Animals
• Arteries (drug effects)
• Dogs
• Energy Metabolism (drug effects)
• Hindlimb (blood supply)
• Humans
• Ischemia (physiopathology)
• Microsurgery
• Phosphoenolpyruvate (pharmacology)
• Postoperative Complications (physiopathology)
• Spasm (physiopathology)
• Vasoconstriction (drug effects)
• Veins (drug effects)