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Related Experiment Videos

[Antithrombin III--an important factor in long-lasting microvascular operations].

B D Partecke, C Fischer, D Buck-Gramcko

    Handchirurgie, Mikrochirurgie, Plastische Chirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse : Organ Der V
    |March 1, 1985
    PubMed
    Summary

    Antithrombin III (AT III) levels drop during long microvascular surgeries, increasing thrombosis risk. Supplementing AT III during procedures can prevent this dangerous decrease.

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    Area of Science:

    • Biochemistry
    • Vascular Surgery
    • Hematology

    Background:

    • Antithrombin III (AT III) is a critical anticoagulant protein.
    • Heparin's antithrombotic action relies on AT III.
    • AT III levels decrease during extended surgeries like gynecological and visceral procedures.

    Observation:

    • Serum AT III concentration significantly decreases during prolonged microvascular procedures, such as free flap or toe transfers.
    • Factors influencing AT III reduction include operation duration, ischemia time, and patient's preoperative AT III levels.
    • Observed an average 21.7% decrease in AT III levels in ten patients, with three dropping below 80%.

    Findings:

    • In some cases, AT III levels fell to 60-65% by the end of long microvascular operations.

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  • Administering active AT III with heparin during surgery can prevent this decline.
  • Local AT III application before anastomosis is effective in preventing thrombosis of anastomosed vessels.

    • Implications:

    • Monitoring AT III levels during long microvascular procedures is recommended.
    • Prophylactic AT III administration can mitigate intraoperative anticoagulant factor depletion.
    • Careful microsurgical technique remains paramount despite AT III supplementation to prevent thrombosis.