The comparison of bemiparin sodium and dabigatran etexilate substances after anastomosis which made in the rat carotid arteries on development on neointima ant thrombolytic efficacy

The comparison of bemiparine sodium and dabigatran etexilate substances after anastomosis which made in the rat carotid arteries on development of neointima and thrombolytic efficacy. Pınar AYDIN, Dicle University Faculty of Medicine, Department of Neurosurgery, Diyarbakır. Background and Objectives: Cerebral ischemia is unable to maintain the necessary conditions for the cerebral tissue oxygenation depending on the reduction of arterial blood flow. The results of reperfusion after ischemia occurring in oxygen reaching ischemic tissue, increasing reactive oxygen species can cause secondary damage. Therefore, revascularization before infarct development will be decreased the degree of morbidity. The success of the techniques of revascularization less than expected because of spontaneous thrombosis or restenosis. After vascular reconstructive procedures acute thrombus formation results with abrupt closure. At the same time in the late period smooth muscle cell migration, proliferation and extracellular matrix accumulation will be caused restenosis with intimal hyperplasia. Dabigatran is a direct thrombin inhibitor. Bemiparin sodium is a second generation low molecular weight heparin. Because of these we researched and compared bemiparin sodium and dabigatran etexilate substances after anastomosis which made in treat carotid arteries on development of neointima and thrombolytic efficacy. Material and Method: In our work randomly chosen, Sprague-Dawley type, male or female 24 rats used. On the day of experiment, 80mg/kg ketamine + 10 mg/kg xylazine was given for anestesia, after 4 hour fasting. The rats right side carotid artery was used for anastomosis an the left side carotid artery was used for controlling. After sterilization the common carotid artery was explored by making a horizontal neck incision. Then the carotid artery was dissected and transected. Anastomosis was applied with 10/0 polypropylene suture. The rats were seperated into 3 groups. Group 1 rats were control group. Group 2 rats were dabigatran group which 10 mg/kg dose of dabigatran etexilate were given oral gavage through 7 days. Group 3 rats were bemiparin group which 250 IU/kg dose of bemiparin sodium were given subcutaneously through 7 days. After seven days treatment, the right carotid artery which were anastomosis and the left carotid artery which were not anastomosis were removed and sent to patology laboratory. The biopsies obtained were preserved in formalin solution, stained with hematoxylin-eosin and examined by the same pathologist. Lumen diamater, lumen area, tunica media thickness, edema, vessel wall injury, intimal hyperplasia, thrombus and inflammation were evaluated. Results: Bemiparin sodium used after anastomosis caused less thickening of tunica media and reduced intimal hyperplasia, but didn't decrease lumen diamater and area. Dabigatran etexilate increased edema and inflammation, but didn't prevent intimal hyperplasia. Conclusion: Bemiparin reduced intimal hyperplasia, prevented thrombosis angiogenesis but dabigatran didn't prevent intimal hiperplasia and its anticoagulation effect was more than antithrombotic effect. key words: Rat, Anastomosis, Intimal hyperplasia, Restenosis, Bemiparin sodium, Dabigatran etexilate.