The effects of ticagrelor on blood flow of microvascular anastomosis in rats

ABSTRACT THE EFFECTS OF TICAGRELOR ON BLOOD FLOW OF MICROVASCULAR ANASTOMOSIS IN RATS With the development of microvascular surgery, many surgical procedures which were seen to be impossible, such as replantation of end-organs, have become applicable. Thrombus formations are the most common complications after free flap transfers with microvascular anastomosis and replantation of severed extremities with vein anastomoses performed by microsurgical techniques. The resulting thrombi cause loss of extremity or free flap necrosis by causing anastomotic obstruction. Ticagrelor, an antiplatelet agent, acts as an adenosine-di-phospate (ADP) receptor antagonist that can inhibit ADP-dependent platelet activation and aggregation. In this study, a total of 14 Wistar albino rats were used as 7 control and 7 study groups. Femoral arteries of subjects in both groups were anastomosed by microsurgical techniques after being cut. Rats in the study group were given 2x10 mg / kg dose of ticagrelor orally for 14 days postoperatively starting 24 hours before the surgery. At the end of the study, we made milking test and we observed continuity of the flow at all of the ticagrelor group (100%) and 3 of the control group (42,8%). In the microscopic examination; the edema was observed in 42,8% of the ticagelor group 71,4% of the control group, increase of inflammation was observed in 14,3% of the ticagelor group while this ratio to rise 71,4% in the control group and endothelialisation was observed in 85,7% of the ticagrelor group, this rate stayed at 42,8% in the control group. There was no statistically significant difference on these parameters (p>0,05). But we think may exist significant difference when increasing the number of subjects. Proceeding from here, ticagrelor was thought to prevent postoperative thrombus formation in the same operations which contain microvascular anastomosis and may prevent extremity or tissue loss in this way. Kerywords: Microvascular anastomosis, thrombus, ticagrelor.