The effect of postoperative administration of low-molecular-weight-heparin (tinzaparin) on arterial thrombosis in an experimental rat model

Yıl 2024, Cilt: 5 Sayı: 2, 53 - 59, 29.07.2024

Yıldırım Gültekin Ali Bolat Merih Özbayburt Hatice Aktaş Atike Tekeli Kunt

Öz

Introduction: : Low molecular weight heparins are licensed in the prophylaxis of venous thromboembolism but not of arterial thrombosis. This study aimed to evaluate the effect of postoperative administration of low molecular weight heparin, tinzaparin, on the rate of arterial thrombosis in a rat model.
Method: The right femoral arteries of sixteen male Wistar Albino rats were incised transversely and then were repaired with a continuous suture. Eight rats were given 175 IU/kg/day tinzaparin postoperatively for three days, while the remaining eight rats were kept free of tinzaparin. All rats were controlled daily for vascular circulation, bleeding, and hematoma until the reoperation on the fourth postoperative day. Reoperation was performed to explore vascular patency and excise a sample of vascular tissue from the repaired femoral artery for histopathological examination. A blood sample was also withdrawn for the detection of anti-factor Xa activity to show the efficacy of tinzaparin.
Results: During the postoperative three-day follow-up period, while vascular circulation disorder was detected in none of the tinzaparin-treated rats, it was detected in two rats not treated with tinzaparin (25%). None of the rats in either group developed bleeding or hematoma at the surgical site. Anti-factor Xa activity in the rats treated with tinzaparin postoperatively was found to be significantly higher than in the rats not treated with tinzaparin (p<0.001). Histopathological examination revealed thrombus and fibrin formation at the femoral artery incision line in only one rat (12.5%) treated with tinzaparin, and in seven rats (87.5%) not treated with tinzaparin (p˂0.001). Intimal hyperplasia was not detected in any group, but mixed-type inflammatory cell infiltration and endothelial and fibroblastic activity around the sutures were noted in both.
Conclusion: The postoperative subcutaneous administration of 175 IU/kg/day tinzaparin effectively attenuates the rate of arterial thrombosis in arterial surgical interventions in a rat model.

Anahtar Kelimeler

Arterial thrombosis, Low molecular weight heparin, Tinzaparin

Deneysel rat modelinde postoperatif düşük molekül ağırlıklı heparin (tinzaparin) uygulamasının arteriyel tromboz üzerine etkisi

Öz

Giriş: : Düşük molekül ağırlıklı heparinler, venöz tromboemboli profilaksisinde ruhsatlıdır ancak arteriyel tromboz profilaksisinde ruhsatlı değildir. Bu çalışmada sıçan modelinde postoperatif düşük molekül ağırlıklı heparin tinzaparin uygulamasının arteriyel tromboz oranına etkisinin değerlendirilmesi amaçlandı.
Yöntem: On altı erkek Wistar Albino sıçanın sağ femoral arterleri transvers olarak kesildi ve daha sonra sürekli dikişle onarıldı. Sekiz sıçana postoperatif üç gün boyunca 175 IU/kg/gün tinzaparin verilirken, geri kalan sekiz sıçana tinzaparin verilmedi. Tüm sıçanlar ameliyat sonrası dördüncü günde tekrar ameliyata alınana kadar damar dolaşımı, kanama ve hematom açısından günlük olarak kontrol edildi. Vasküler açıklığı araştırmak ve histopatolojik inceleme için onarılan femoral arterden bir vasküler doku örneğini çıkarmak için yeniden ameliyat yapıldı. Tinzaparinin etkinliğini göstermek amacıyla anti-faktör Xa aktivitesinin saptanması için de bir kan örneği alındı.
Bulgular: Ameliyat sonrası üç günlük takipte tinzaparin uygulanan sıçanların hiçbirinde damar dolaşım bozukluğu saptanmazken, tinzaparin tedavisi uygulanmayan iki sıçanda (%25) damar dolaşım bozukluğu tespit edildi. Her iki gruptaki sıçanların hiçbirinde cerrahi bölgede kanama veya hematom gelişmedi. Postoperatif dönemde tinzaparin uygulanan sıçanlarda anti-faktör Xa aktivitesinin, tinzaparin uygulanmayan sıçanlara göre anlamlı derecede yüksek olduğu görüldü (p<0,001). Histopatolojik incelemede tinzaparin tedavisi gören yalnızca bir sıçanda (%12,5) ve tinzaparin tedavisi görmeyen yedi sıçanda (%87,5) femoral arter insizyon hattında trombüs ve fibrin oluşumu saptandı (p˂0,001). Hiçbir grupta intimal hiperplazi saptanmadı ancak her iki grupta da karışık tipte inflamatuar hücre infiltrasyonu ve sütür çevresinde endotelyal ve fibroblastik aktivite dikkat çekti.
Sonuç: Sıçan modelinde postoperatif subkutan 175 IU/kg/gün tinzaparin uygulamasının arteriyel cerrahi girişimlerde arteriyel tromboz oranını etkili bir şekilde azalttığı görüldü.

Anahtar Kelimeler

Arteriyel tromboz, Düşük molekül ağırlıklı heparin, Tinzaparin

Destekleyen Kurum

KIRIKKALE ÜNİVERSİTESİ BİLİMSEL ARAŞTIRMA PROJE (BAP) BİRİMİ

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