Thrombus formation and endothelial alterations in microarterial anastomoses

Area of Science:

• Vascular Surgery
• Hematology
• Microscopy

Background:

• End-to-side arterial anastomosis is a common surgical procedure.
• Understanding the immediate postoperative thrombotic response is crucial for preventing complications.

Purpose of the Study:

• To investigate the sequential hematological and endothelial responses after arterial anastomosis in small vessels.
• To evaluate the efficacy of different anticoagulant regimens in mitigating thrombus formation.

Main Methods:

• Scanning electron microscopy was used to examine vessel lumens post-anastomosis.
• Various anticoagulant regimens, including aspirin and heparin, were tested.

Main Results:

• Transient thrombus formation, primarily of platelets, occurred within 15-30 minutes after flow restoration.
• Aspirin and intraoperative heparin irrigation were ineffective; systemic heparin significantly reduced thrombus.
• Short-term intravenous heparin (5 minutes) was as effective as long-term heparin.

Conclusions:

• Thrombotic occlusion after arterial anastomosis is most likely to occur within the first 30 minutes.
• Systemic heparin therapy is effective in reducing postoperative thrombotic responses in small arterial anastomoses.