Desirudin reduces the rate of microvenous thrombosis in a rat model.

Abstract

OBJECTIVES:

In an effort to evaluate pharmacologic agents for optimal anticoagulant prophylaxis in patients undergoing free tissue transfer, we evaluated the efficacy of desirudin (Canyon Pharmaceuticals, Hunt Valley, MD), a recombinant hirudin that acts as a direct thrombin inhibitor, using a rat model of microvenous thrombosis.

STUDY DESIGN:

Randomized, blinded study using an in vivo rat model of microvenous failure.

METHODS:

Thirty-two rats received either desirudin or saline in a randomized, blinded fashion 30 minutes prior to performance of a standardized thrombogenic procedure on rat femoral veins. Bleeding time, vessel patency, and presence of clot within the anastomosis were subsequently assessed. Appropriate statistical analyses were then performed.

RESULTS:

There was a significant increase in vessel patency in rats treated preoperatively with desirudin compared to controls receiving saline (96.9% vs. 53.1%, P < .001). In evaluating patent vessels for non-occluding clot, 41.2% of control rats had non-obstructive clot at the site of anastomosis, versus 3.2% of rats treated with desirudin (P = .002). Bleeding times were longer in desirudin-treated rats than those that received saline (7.17 +/- 3 minutes vs. 5.15 +/- 1.2 minutes, P = .027).

CONCLUSIONS:

The use of preoperative desirudin increases the rate of microvascular anastomotic patency, decreases the occurrence of non-occluding clot, and increases bleeding time in an in vivo rat model, indicating potential efficacy in patients undergoing microvascular free tissue transfer.

• Authors: Carol M Lewis, Daniel G Deschler
• Journal: The Laryngoscope (Laryngoscope) Vol. 118 Issue 7 Pg. 1149-52 (Jul 2008) ISSN: 1531-4995 [Electronic] United States
• PMID: 18401270 (Publication Type: Journal Article)

Chemical References

• Fibrinolytic Agents
• Hirudins
• Recombinant Proteins
• desirudin

Topics

• Anastomosis, Surgical
• Animals
• Disease Models, Animal
• Fibrinolytic Agents (pharmacology)
• Graft Survival (drug effects)
• Hirudins (pharmacology)
• Male
• Microcirculation (drug effects, surgery)
• Microsurgery
• Preoperative Care
• Rats
• Rats, Sprague-Dawley
• Recombinant Proteins (pharmacology)
• Surgical Flaps (blood supply)
• Thrombosis (prevention & control)