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Related Experiment Videos

Recombinant hirudin--initial observations in reconstructive microsurgery.

K Narayanan1, J M Walenga, M D Liang

  • 1Montefiore Hospital, Division of Plastic Surgery, Pittsburgh, Pa.

Haemostasis
|January 1, 1991
PubMed
Summary
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Hirudinized saline and heparinized saline effectively prevent thrombosis in microsurgery anastomosis, outperforming saline alone. Hirudin offers a promising alternative with reduced bleeding risk in microvascular procedures.

Area of Science:

  • Vascular Surgery
  • Thrombosis Research
  • Pharmacology

Background:

  • Microvascular free tissue transfers have high success rates but a 10-15% failure rate due to anastomotic site thrombosis.
  • Anticoagulants like heparin can reduce thrombosis but may increase bleeding.
  • Hirudin, a potent thrombin inhibitor, is available via recombinant technology.

Purpose of the Study:

  • To assess the efficacy of hirudinized saline as an irrigant in microsurgery anastomosis.
  • To compare hirudinized saline with heparinized saline and saline alone in preventing thrombosis.
  • To evaluate the safety profile, specifically bleeding risk, of hirudin in microsurgery.

Main Methods:

  • Utilized 75 male Sprague-Dawley rats in a microsurgery model of arterial anastomosis.

Related Experiment Videos

  • Exposed and divided the right femoral artery, then irrigated with hirudinized saline, heparinized saline, or saline alone.
  • Observed vessel patency over a 3-day period to assess thrombosis prevention.

    • Main Results:

    • Hirudinized saline and heparinized saline demonstrated comparable performance in preventing thrombosis.
    • Both hirudinized and heparinized saline were superior to saline alone in preventing vessel thrombosis.
    • Initial data suggest a reduced bleeding risk associated with hirudin compared to heparin.

    Conclusions:

    • Hirudinized saline is an effective irrigant for preventing thrombosis in microsurgical anastomosis.
    • Hirudin shows comparable efficacy to heparin with a potentially lower risk of bleeding.
    • Hirudin represents a potentially useful anticoagulant agent for microvascular surgery.