Thrombosis Prevention with Botulinum Toxin A after Traumatic Crush Injury in a Rat Model

Hassanpour, Seyed Esmail; Tarahomi, Mohammadreza; Daryani, Amir

doi:10.1055/s-0037-1607437

Cited by 4 publications

(6 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other protocols have been used and evaluated to try to reduce the thrombosis rate during microsurgical anastomoses. Hassanpour et al 20 have more recently demonstrated, in an animal study, the protective effect of perivascular injection of botulinum toxin A against intravascular thrombosis. The toxin would reduce the effects of vasoconstrictor chemical stress and lead to vasodilation and protection against microsurgical thrombosis during anastomosis.…”

Section: Discussionmentioning

confidence: 96%

Decrease of Thrombosis in Microsurgical Anastomoses: The Use of Intraoperative Pure Intraluminal Unfractionated Heparin

Ramelli

Durry

Ruffenach

et al. 2019

J reconstr Microsurg

View full text Add to dashboard Cite

Background Unfractionated heparin has anticoagulant properties by catalyzing antithrombin III, which inactivates coagulation enzymes. Used in microsurgery, it would prevent the occurrence of thrombosis during microsurgical anastomoses. The objective of this study was to evaluate the role of intraoperative irrigation of the vascular lumen with pure sodium heparin to prevent vascular thrombosis after end-to-end microsurgical anastomoses. Methods End-to-end anastomoses were performed on rats by 21 operators. Three surgical sites were studied (cervical, femoral, and rat tail). The first vessel was irrigated with physiological salt solution (0.9%) before, during, and before the end of the anastomosis. Whenever possible, the contralateral vessel was irrigated with pure unfractionated heparin 5,000 UI/mL. The primary endpoint was the occurrence of thrombosis 60 minutes after anastomosis. Results From November 2015 to April 2018, 247 anastomoses were performed on 229 arteries and 18 veins. One hundred twenty-five anastomoses were irrigated with physiological salt solution, 122 with pure unfractionated heparin. A 60-minute thrombosis was found on 31 anastomoses (25%) irrigated with physiological salt solution compared with 16 anastomoses (13%) irrigated with heparin, that is, a decrease in the thrombosis rate of 2.6 (p = 0.01). Conclusion The use of pure unfractionated heparin in intraoperative lumen irrigation during microsurgical end-to-end anastomoses reduces the rate of vascular 60-minute thrombosis compared with physiological salt solution irrigation. It is an effective intraoperative procedure for the prevention of microsurgical thrombosis.

show abstract

Section: Discussionmentioning

confidence: 96%

Decrease of Thrombosis in Microsurgical Anastomoses: The Use of Intraoperative Pure Intraluminal Unfractionated Heparin

Ramelli

Durry

Ruffenach

et al. 2019

J reconstr Microsurg

View full text Add to dashboard Cite

show abstract

“…In high risk patients the subsequent procedure is considered to be the safer option as the blood supply provided by the loop is more reliable and the operation time is reduced. Reconsidering the reconstructive algorithm, the two-stage procedure should have been the primary option instead of risking flap loss and the posterior tibial artery by performing an end-to-end anastomosis [ 7 ], [ 8 ], [ 9 ], [ 11 ], [ 13 ], [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…From a microsurgeon’s point of view crush injuries impose a technical challenge due to the extensive intima damage surpassing the initial injury zone. Evaluating the extent of the vascular damage is challenging; the mechanisms and possible preventions of early clotting and/or thrombosis are currently studied in several rodent models [ 7 ], [ 8 ], [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Multistep reconstruction of a post-traumatic defect in the lower limb with AV loop and free myocutaneous latissimus dorsi flap combined with a perforator monitor skin island after loss of ALT flap

Summer

Mrad

Bota

et al. 2021

GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW; 10:Doc05

View full text Add to dashboard Cite

“…This was observed in a standard model for crush injury in the rat femoral artery that demonstrated the antithrombotic effect of perivascular BTX-A injection and maintenance of pulsatile bleeding. 33 One of the major reasons for thrombosis is sustained vasospasm. There was a 62% absolute risk reduction of thrombosis within both arteries and veins following BTX administration when compared with saline control.…”

Section: Discussionmentioning

confidence: 99%

Botulinum Toxin A and B Improve Perfusion, Increase Flap Survival, Cause Vasodilation, and Prevent Thrombosis: A Systematic Review and Meta-analysis of Controlled Animal Studies

Goldberg

Gehrman

Graham

2021

Hand (New York, N,Y.)

View full text Add to dashboard Cite

Background: A systematic review and meta-analysis of case-control animal model studies will help clarify the vascular effects of botulinum toxin (BTX). Methods: Preferred Reporting Items of Systematic reviews and Meta-Analyses guidelines were used to identify all animal case-control studies published before September 13, 2020, evaluating the vascular effects of BTX. Primary parameters included the following: perfusion, flap survival, arterial and venous dilation, and arterial and venous thrombosis. Results: Thirty-six studies with 1032 animals met the systematic review inclusion criteria. Twenty-nine studies had quantifiable data for statistical analysis. Statistically significant increases in perfusion with BTX over saline were detected within 1 day and sustained up to 8 weeks. The following represent weighted mean data from the meta-analysis. The administration of BTX has a 26% increase in both random pattern and pedicled flap survival area over controls. Botulinum toxin causes vasodilation. Botulinum toxin increases vessel diameter in arteries by 40% and in veins by 46% compared with saline controls. The administration of BTX reduces thrombosis by 85% in arteries and by 79% in veins compared with saline controls. Vascular effects were consistent across both BTX-A and BTX-B serotypes, multiple animal species, and various doses. No clear relationships between vascular effects and BTX pretreatment time were identified. Conclusions: Perivascular BTX administration intraoperatively or as a chemical delay pretreatment several days before surgery in multiple animal species and models shows multiple changes to the vascular system. Extrapolation of lessons learned from this systematic review and meta-analysis of animal models could expand research and clinical use of BTX in human vascular disease and surgery.

show abstract

Thrombosis Prevention with Botulinum Toxin A after Traumatic Crush Injury in a Rat Model

Cited by 4 publications

References 24 publications

Decrease of Thrombosis in Microsurgical Anastomoses: The Use of Intraoperative Pure Intraluminal Unfractionated Heparin

Decrease of Thrombosis in Microsurgical Anastomoses: The Use of Intraoperative Pure Intraluminal Unfractionated Heparin

Multistep reconstruction of a post-traumatic defect in the lower limb with AV loop and free myocutaneous latissimus dorsi flap combined with a perforator monitor skin island after loss of ALT flap

Botulinum Toxin A and B Improve Perfusion, Increase Flap Survival, Cause Vasodilation, and Prevent Thrombosis: A Systematic Review and Meta-analysis of Controlled Animal Studies

Contact Info

Product

Resources

About