Related Experiment Video
Updated: Jun 29, 2025
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Prophylaxis of microvascular thrombosis using direct oral anticoagulants (DOAC) in microvascular free tissue
Frizzi Bschorer1, Reinhard Bschorer2
1Department of Oral and Maxillofacial Surgery, Helios Kliniken Schwerin, Wismarsche Straße 393-397, 19049, Schwerin, Germany; MKG-Praxis Am Stadthafen, Schliemannstr. 18, 19055, Schwerin, Germany; Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center Rostock, Schillingallee 35, 18057, Rostock, Germany.
Introduction:
We conducted this pilot study to assess direct oral anticoagulants (DOACs) in the prevention of microvascular thrombosis.
Materials And Methods:
Five patients undergoing microvascular free tissue transplantation received rivaroxaban or apixaban (depending on their home medication). We compared this group to 19 patients who received enoxaparin subcutaneously. We evaluated the rate of graft loss due to microvascular thrombosis and the number of transfusions administered intra- and postoperatively.
Results:
There was no graft loss due to microvascular thrombosis in either of the groups. There was no significant difference in the number of intraoperative (study group mean 1.00 (SE 0.32) vs. control group mean 1.11 (SE 0.59); p = 0.876) and postoperative (study group mean 1.2 (SE 0.37) vs. control group mean 1.74 (SE 0.34); p = 0.310) red blood cell transfusions.
Conclusion:
Based on our results in this pilot study, DOACs can be used with microvascular flaps. Further studies with larger sample sizes should be performed to find an optimal medication regimen both for patients already taking DOACs and perhaps even for those not taking DOACs.
