Subject(s)
Intestine, Small/blood supply , Ischemia/surgery , Acute Disease , Humans , Intestine, Small/surgery , Male , Middle Aged , ReoperationABSTRACT
A sensitive animal model was used to investigate treatment designed to improve vascular graft patency. A Dacron graft was inserted into the infrarenal vena cava of 30 rabbits. Half were treated with subcutaneous Arvin for 28 days after operation. This produced a significant lowering of the post operative plasma fibrinogen. The patency rate of the grafts in the treated rabbits was significantly greater than in the control rabbits.
Subject(s)
Ancrod/pharmacology , Blood Vessel Prosthesis , Endopeptidases/pharmacology , Fibrinogen , Animals , Fibrinogen/analysis , Polyethylene Terephthalates , Rabbits , Vena Cava, Inferior/surgeryABSTRACT
The plasma fibrinogen concentration is directly related to blood viscosity, which in turn is inversely related to blood flow. The way in which the plasma fibrinogen level affects the clinical status of patients with peripheral vascular disease is discussed with reference to both retrospective and prospective studies of patients undergoing major arterial surgery. Animal experiments are described in which the effect of reducing the plasma fibrinogen level with oral clofibrate and parenteral Arvin (ancrod) on the patency of Dacron arterial grafts was studied.
Subject(s)
Fibrinogen/analysis , Vascular Surgical Procedures , Ancrod/pharmacology , Animals , Blood Flow Velocity , Blood Vessels/anatomy & histology , Blood Viscosity/drug effects , Body Temperature , Clofibrate/pharmacology , Depression, Chemical , Hematocrit , Humans , Intermittent Claudication/drug therapy , Postoperative Complications , RabbitsABSTRACT
Ankle systolic pressure measurements in 67 patients with intermittent claudication treated with Clofibrate for an average period of 11 months and 32 untreated patients suggest that 1) patients with a raised initial plasma fibrinogen concentration have more severe disease than those with low initial plasma fibrinogen concentration and 2) the response to treatment with Clofibrate is significantly better in those with a raised plasma fibrinogen concentration. On the basis of the patients own estimation of their claudication distance there was marked symptomatic inprovement in the treated patients. There was also a significant decrease in mean plasma fibrinogen levels in the treated patients and it is suggested that the hypofibrinogenemic effect of Clofibrate may be responsible for the benefit of this drug in patients with vascular disease.
