Prevention of venous thrombosis in microvascular surgery by transmural release of heparin from a polyanhydride polymer.
BACKGROUND: The effects of transmurally released heparin on the patency of microvenous anastomoses were studied by using a bioerodible polymer delivery system in a rat microvascular thrombosis model. METHODS: A polyanhydride carrier with heparin was wrapped around the outside of a highly thrombogenic venous inversion graft in 14 animals, and patency rates were compared with those of 17 control animals. RESULTS: Anastomotic patency was significantly greater in the groups treated with transmurally released heparin, measured both at 24 hours (86% versus 16%; p < 0.02) and at 7 days (86% versus 36%; p < 0.05) after operation. No significant complications occurred. CONCLUSIONS: Controlled release of heparin by transmural delivery is an effective and safe form of local antithrombotic therapy and may have applications both in microvascular and large vessel surgery.
Orloff, LA; Glenn, MG; Domb, AJ; Esclamado, RA
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