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The pathogenesis of thrombosis in venous prostheses
T Itoh1, E Shiba, J Kambayashi
1Second Department of Surgery, Osaka University Medical School, Japan.
European Journal of Vascular Surgery
|December 1, 1990
Summary
This study investigated thrombosis in synthetic venous grafts in rabbits. Ticlopidine and warfarin combination therapy significantly reduced thrombus formation and maintained graft patency compared to controls.
Area of Science:
- Vascular Surgery
- Biomaterials Science
- Thrombosis Research
Background:
- Synthetic venous grafts are prone to thrombosis, a major cause of graft failure.
- Understanding the pathogenesis of thrombosis is crucial for improving graft outcomes.
Purpose of the Study:
- To evaluate the pathogenesis of thrombosis in synthetic venous grafts.
- To assess the efficacy of ticlopidine hydrochloride and warfarin sodium in preventing thrombosis and maintaining graft patency.
Main Methods:
- Rabbits underwent inferior vena cava replacement with woven Tetron grafts.
- Animals were assigned to control (no medication) or treatment groups receiving ticlopidine, warfarin, or a combination.
- Graft patency, thrombus formation, and intimal hyperplasia were evaluated at various time points using microscopy and dry weight measurements.
Main Results:
- Control grafts occluded within 3 hours.
- Ticlopidine and combination therapy maintained graft patency until day 28, with reduced thrombus weight.
- Warfarin monotherapy resulted in graft occlusion by day 14-28.
- Endothelial-like cell coverage was observed in drug-treated groups by day 7.
Conclusions:
- Ticlopidine hydrochloride, particularly in combination with warfarin, effectively reduces thrombosis and maintains patency in synthetic venous grafts.
- Intimal hyperplasia is a significant factor in graft lumen narrowing.
- Pharmacological intervention is critical for improving the long-term success of synthetic venous grafts.