Association of Vascular Injury with the Proximal Side Branch and Assessment of Thrombosis Rates in a New Microarterial Traction Model

ABSTRACT

The higher rate of anastomotic failure in avulsion injuries has been attributed mostly to the uncertainty in determining the uninjured vessel segment suitable for anastomosis and resection past a proximal branch that has been proposed to achieve good arterial flow. A graded, longitudinal, microarterial traction model in rats has been used to examine the histopathologic aspects of the extent of vascular injury and its association with the proximal side branch. Additionally, anastomoses were performed following traction, and thromboses rates were determined. Results indicated a more proximal vessel injury with increasing rates of traction and, although the vessel segment proximal to the side branch was spared, up to a certain degree of traction, the injury extended beyond this point with more aggressive traction force. Consistently increasing rates of thromboses, significantly higher than the control group, were demonstrated. This model may be of use in further studies on the efficacy of various antithrombotic agents.

KEYWORDS

Traction model - proximal side branch - microarterial thrombosis

REFERENCES

• 1 Morrison W A, O'Brien BMcC, MacLeod A M. A long-term review of digital replantation.  Aust NZ J Surg. 1977;  47 767-773
• 2 Kersh R A, Handren J, Hergrueter C, May J W. Microvascular surgical experimental thrombosis model: rationale and design.  Plast Reconstr Surg. 1989;  83 866-872
• 3 Mitchell G M, Morrison W A, Papadopoulos A, O'Brien B M. A study of the extent and pathology of experimental avulsion injury in rabbit arteries and veins.  Br J Plast Surg. 1985;  38 278-287
• 4 Zeeman B J, Mitchell G M, Olazabal A E, Collopy P A, Morrison W A, O'Brien B M. The significance of resection length on the patency rate, and the histopathology of experimentally avulsed and microsurgically repaired blood vessels.  Br J Plas Surg. 1988;  41 509-514
• 5 Van Beek A L, Kutz J E, Zook E G. Importance of the ribbon sign, indicating unsuitability of the vessel, in replanting a finger.  Plast Reconstr Surg. 1978;  61 32-35
• 6 Parmaksizoglu F, Beyzadeoglu T. Role of side branches in determining suitable arterial segments for anastomosis in avulsion injuries: experimental studies.  J Reconstr Microsurg. 2003;  19 279-284
• 7 Glover M G, Seaber A V, Urbaniak J R. Intimal tears and their relationship to long-term patency in the rat femoral artery.  Microsurgery. 1986;  7 124-127
• 8 Glover M G, Seaber A V, Urbaniak J R. Arterial intimal damage in avulsion and crush injuries in rat limbs.  J Reconstr Microsurg. 1985;  1 247-251
• 9 Mitchell G M, Frykman G K, Morrison W A, O'Brien B M. The nature and extent of histopathologic injury in human avulsed arteries and veins and in experimentally avulsed monkey arteries.  Plast Reconstr Surg. 1986;  78 801-810
• 10 Mitchell G M, McCann J J, Rogers I W, Hickey M J, Morrison W A, O'Brien B M. A morphological study of the long-term repair process in experimentally stretched but unruptured arteries and veins.  Br J Plast Surg. 1996;  49 34-40
• 11 Chen L E, Seaber A V, Glisson R R, Mikat E M, Urbaniak J R. Morphologic and morphometric analyses of rat femoral arteries after crush injury.  Microsurgery. 1991;  12 402-411
• 12 Cooley B C, Ruas E J, Wilgis E F. Scanning electron microscopy of crush/avulsion arterial trauma: effect of heparin and aspirin administration.  Microsurgery. 1987;  8 11-16
• 13 Rooks M D, Rodriquez J, McNaughton M, Turnidge K, Zusmanis K, Hutton W. Refinement of the rat crush-avulsion femoral artery injury model.  Microsurgery. 1993;  14 130-134