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Local Administration of Nitric Oxide Donor Significantly Impacts Microvascular Thrombosis
Author(s) -
Chiang Scott,
Azizzadeh Babak,
Buga Georgette,
Ignarro Lou,
Calcaterra Thomas,
Blackwell Keith
Publication year - 2003
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200303000-00003
Subject(s) - nitric oxide , medicine , anesthesia , femoral artery , thrombosis , nitric oxide synthase , vasodilation , sodium nitroprusside , pharmacology , surgery , urology
Objectives/Hypothesis Clinical pharmacotherapy has demonstrated a role in preventing microvascular thrombosis in both experimental and clinical settings. Previous studies in the rabbit model have noted an increased rate of thrombosis with intravenous infusion of nitric oxide antagonists. The study assessed the effects of local application of nitric oxide agonists and antagonists on microvascular anastomotic patency rates. Study Design A randomized, prospective analysis. Methods An arterial inversion graft microvascular thrombosis model was used in New Zealand white rabbits. The rabbits were randomly assigned to nitric oxide agonist, antagonist, and control groups. In each rabbit, the common femoral artery was surgically exposed and a 2‐mm arterial inversion graft was harvested. The anastomosis of the graft to the common femoral artery was performed in solutions of either 100 μmol/L spermine NONOate (nitric oxide donor), 100 μmol/L nitro‐L‐arginine‐methyl ester (L‐NAME) (nitric oxide synthase inhibitor), or 0.9% sodium chloride (control) solution. The contralateral common femoral artery also underwent arterial inversion graft testing with the use of the same solution. Arterial patency was assessed 1 hour after anastomosis. Results Sixteen of 22 arterial inversion grafts performed in the spermine NONOate solution remained patent, and 6 of 22 clotted. Eleven of 21 arterial inversion grafts performed in the control solution remained patent, and 10 clotted. Seven of 21 arterial inversion grafts performed in the L‐NAME solution remained patent, and 14 clotted. These results were found to be statistically significant using the χ 2 test with a P value of less than .05. Conclusions In the rabbit model, local application of nitric oxide agonists and antagonists can significantly impact anastomotic patency rates. Further studies may demonstrate a role for the clinical use of nitric oxide in microvascular surgery.