Current status of topical antithrombotic agents in microvascular surgery

Several technical advances over the years have allowed microsurgery to be successful. However, thrombosis, particularly at the anastomosis site, remains a complication of microvascular surgery. Various preventive measures, including drugs, have been used to improve microvascular surgical anastomotic patency rates. The purpose of this article is to review the literature and the current status of topical antithrombotic agents. From this review along with laboratory investigations it is concluded that a combination of topical as well as systemic agents offers the best patency rates. However, the "ideal" antithrombotic agent is yet to be discovered and investigations need to be continued in order to improve or eliminate the complication of microvascular thrombosis. But the importance of atraumatic technique cannot be overemphasized.