Low-molecular-weight heparin exerts an early antithrombotic effect in small arteries and veins following severe trauma.

Abstract

Administration of low-molecular-weight heparin (LMWH) and standard heparin was studied by evaluating vessel bleeding, patency, and thrombotic material following severe vascular trauma. Arteriotomy and intimectomy or venotomy and intimectomy were performed on small rabbit arteries or veins in two separate blinded studies. All vessels were closed using a continuous microvascular suture. Patency and weight of thrombotic materials were evaluated 2 hr after reperfusion. In the arterial study, two groups of 23-24 arteries were treated with saline or LMWH systemically. Bleeding times were 89 +/- 15 sec in the control group and 103 +/- 27 sec in the LMWH group; there was no significant difference between the groups. Patency was significantly increased in the LMWH group (79%) compared to the control group (52%). The weight of thrombotic material in the LMWH group (1.39 +/- 0.20 mg per artery) was significantly different compared to the control group (2.19 +/- 0.22 mg per artery). In the venous study, 65 veins were divided into three groups (21-23 vessels/group) and treated with systemic saline, heparin, or LMWH. Bleeding times in the conventional heparin group (37 +/- 7 sec), the control group (23 +/- 3 sec), and LMWH group (22 +/- 4 sec) were not significantly different. The patency rates were significantly increased in the heparin (42%) and LMWH (39%) groups compared to the control group (0%). The weight of thrombotic material in each vein was significantly less in the LMWH (1.07 +/- 0.24 mg) and heparin (1.78 +/- 0.52 mg) groups than in the control group (3.78 +/- 0.29 mg).(ABSTRACT TRUNCATED AT 250 WORDS)