Effect of Pre-reperfusion Intravascular Rinsing in a Canine Acute Limb Ischemia Model

ABSTRACT

PURPOSE: Reperfusion after acute ischemia is associated with high rates of morbidity and mortality due to the ischemic injury itself and the following myonephropathic metabolic syndrome, in spite of complete revascularization. Therefore, we attempted to verify the difference in reperfusion injury with or without pre-reperfusion intravascular rinsing in a canine acute limb ischemia model. METHOD: We used five female mongrel dogs. Complete acute hind limb ischemia was induced by infrarenal aortic and bilateral femoral artery clamping for 8 hours. We divided the dogs into two groups. In the rinse group (RG) three dogs were declamped with intravascular rinsing, and in the non-rinse group (non-RG) two dogs were declamped without any additional procedures. The perfusate solution was infused through both femoral arteries and was drained via both femoral veins. Serial blood samples were obtained four times. The gastrocnemius muscles were biopsied 3 days after reperfusion. RESULT: The results at preischemia, just before, 30 min, and 3 days after reperfusion were as follows Creatine phosphokinase (CK) was 204, 1031, 1373, and 443 (IU/L) in the RG and 159, 3855, 6345, and 5455 (IU/L) in the non-RG. Lactate dehydrogenase (LDH) was 177, 248, 173, and 232 (IU/L) in the RG and 95, 508, 638, and 878 (IU/L) in the non-RG. Aspartate transaminase (AST) was 23, 50, 43, and 42 (IU/L) in the RG and 19, 118, 154, and 399 (IU/L) in the non-RG. Potassium (K) was 5.7, 5.8, 5.4, and 4.0 (mEq/L) in the RG and 5.4, 5.5, 5.7, and 5.3 (mEq/L) in the non-RG. Muscle injury in the non-RG was more severe than in the RG. CONCLUSION: There was a considerable difference between the groups in the CK, LDH and AST levels and the muscle biopsy findings. The results showed that the intravascular rinsing provided beneficial effects in reperfusion injury acute limb ischemia.