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Venous occlusion was used as a model to examine the action of antithrombotic substances. In 15 healthy volunteers, a blood pressure cuff attached to an arm was inflated to 90 mm Hg for 15 minutes. Blood was collected from an antecubital vein prior to and at the end of occlusion. Parameters of coagulation, of fibrinolysis, and of platelet function were examined.  At the end of occlusion, factors XIa and Xa were demonstrable in intact plasma. There was also a diminution of plasminogen and a shortening of the euglobulin lysis time. Collagen induced platelet aggregation was increased. Platelet factor 4 (PF 4) was diminished in platelets, and was demonstrable in plasma after occlusion.  Three groups were formed from these volunteers. Group 1 received 1500 mg acetylsalicylic acid (ASA) per day, group 2 was injected 5000 units heparin s.c. at 12 hr interval s, and group 3 received both drugs. After one week of therapy, blood samples were again collected before and after occlusion. In the ASA group, platelet aggregation was diminished. This was not altered by occlusion. PF 4 was neither diminished in platelets nor was it demonstrable in plasma. There was no influence on plasmatic coagulation factors nor on fibrinolysis. In the heparin group, factors XIa and Xa were not demonstrable in plasma after occlusion. There was no PF 4 in plasma though PF 4 in platelets was diminished. Platelet aggregation was not influenced. In the heparin plus ASA group, factors XIa and Xa as well as plasma PF 4 were missing after occlusion. PF 4 in platelets was not diminished whilst platelet aggregation was inhibited.  These experiments demonstrate a mutual support of ASA and heparin in the prevention of alterations of the hemostatic mechanism which are likely to provoke an increased thrombotic tendency.

Influence of Low Dose Heparin and of Acetylsalicylic Acid on Alterations of the Hemostatic Mechanism by Venous Occlusion